监测血浆EBV-DNA含量在鼻咽癌诊疗中的意义

摘要

Objective To investigate the clinical significance of plasma Epstein-Bar virus DNA (EBV-DNA) concentration in the diagnosis and treatment of nasopharyngeal carcinoma (NPC). Methods Fluorescence quantitative PCR was used to determine the content of EBV-DNA in blood serum in 56 patients with NPC (the study group) and 50 healthy individuals (the control group). Results The positive rate of EBV-DNA was 92% (46/ 50) in the study group and 8% (4/50) in the control group. Among the 46 patients detected positive in the study group, 26 patients were detected with significantly decreased EBV-DNA at the first week of treatment, and with no EBV-DNA at the end of the treatment. Fourteen patients were detected with high levels of EBV-DNA at the initial weeks of treatment, but with no EBV-DNA at the end of the treatment. Six patients were found to maintain a high levels of EBV-DNA throughout the treatment. Conclusion Determination of EBV-DNA by fluorescence qualitative PCR in blood serum is reliable and sensitive, which has high clinical value in the diagnosis and treatment of NPC.%目的 探讨鼻咽癌患者放化疗过程中血浆EBV-DNA含量在临床诊疗中的意义.方法 采用荧光定量PCR法检测50例NPC患者在不同的诊疗阶段血浆EBV-DNA的含量,同时设50例健康体检者为阴性对照组.结果 50例NPC组中EBV-DNA检测阳性率为92.0％ (46/50),健康对照组阳性率为8.0％ (4/50);46例EBV-DNA阳性的患者中,26例患者从第一周治疗开始,DNA水平就开始明显下降,至治疗结束前已检测不到DNA的复制;14例患者开始几周DNA水平变化并不明显,至治疗结束前,基本检测不到DNA的复制;6例患者在治疗过程中均可检测到较高水平的EBV-DNA.结论 采用荧光定量PCR方法检测NPC患者血浆中游离的EBV-DNA是一种敏感可靠的方法,对于NPC的早期诊断及预后具有非常重要的临床意义.