Objective To investigate the expression and clinical significance of EBV VCA-IgA, EA-IgA and EBV-DNA in serum of patients with recurrent nasopharyngeal carcinoma. Method 120 cases with recurrent nasopharyngeal carcinoma in Cancer Hospital Chinese Academy of Medical Sciences from August 2014 to June 2016 were selected as recurrence group, and they were divided into surgery group (75 cases) and chemoradiotherapy group (45 cases) according to different treatment methods. Another 40 cases with radiation necrosis of skull base after operation were selected as non-recurrence group. The expression levels of EBV VCA-IgA、EA-IgA and EBV-DNA were analyzed among different groups. Result Before treatment, the positive rate of EBV-DNA in recurrence group was significantly higher than that in non-recurrence group (P < 0.05), while the positive rate of VCA-IgA and EA-IgA showed no significant differences between the two groups (P > 0.05). With the increase of the clinical stages, the positive rate of EBV-DNA in recurrent group was significantly increased (P<0.05), VCA-IgA and EA-IgA showed no differences among different stages (P>0.05). There were no significant differences in VCA-IgA, EBV-DNA and EA-IgA among patients with different recurrence sites (P > 0.05). The positive rate of VCA-IgA, EA-IgA and EBV-DNA showed no significant differences between surgery group and chemoradiotherapy group (P > 0.05). After treatment, the positive rate of EBV-DNA in surgery group was significantly lower than that in chemoradiotherapy group (P<0.05), and there were no differences in the positive rate of VCA-IgA and EA-IgA between the two groups (P>0.05). Conclusion EBV-DNA is helpful to the diagnosis of nasopharyngeal carcinoma recurrence and clinical staging, surgery can help to eliminate the EBV. The positive expression of EBV antibody in patients without recurrent nasopharyngeal carcinoma is high, therefore it can not be used to detect the recurrence of nasopharyngeal carcinoma.%目的 研究EB病毒衣壳抗原IgA(VCA-IgA)、早期抗原IgA(EA-IgA)及EB病毒-DNA (EBV-DNA)在鼻咽癌复发患者血清中的表达水平及其临床意义.方法 选取中国医学科学院肿瘤医院2014年8月至2016年6月收治的120例鼻咽癌复发患者纳入复发组,按照不同治疗方式将其分为手术组(75例)和放化疗组(45例).另选取同期40例经鼻咽癌手术治疗后放射性颅底骨坏死患者纳入未复发组.比较不同组患者血清中EB病毒VCA-IgA、EA-IgA及EBV-DNA的表达水平.结果 治疗前,复发组患者EBV-DNA阳性率显著高于未复发组(P<0.05),而两组患者VCA-IgA与EA-IgA阳性率比较均无显著差异(P>0.05).随着临床分期的递增,复发组患者EBV-DNA阳性率显著升高(P<0.05),而VCA-IgA与EA-IgA阳性率在不同分期中无显著差异(P>0.05);复发组患者不同复发部位中EBV-DNA、VCA-IgA与EA-IgA阳性率比较均无显著差异(P>0.05).治疗前,手术组与放化疗组患者EBV-DNA、VCA-IgA与EA-IgA阳性率比较均无显著差异(P>0.05);治疗后,手术组患者EBV-DNA阳性率显著低于放化疗组(P<0.05),而VCA-IgA与EA-IgA阳性率比较均无显著差异(P>0.05).结论 EBV-DNA有助于辅助诊断鼻咽癌的复发与分期,通过手术治疗能减少患者机体中的EB病毒,EB病毒抗体在未复发鼻咽癌患者的血清中也具有较高的阳性率,所以其不能用于判断鼻咽癌的复发情况.
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