417例初诊鼻咽癌患者血浆EBV-DNA检测结果分析

摘要

目的 回顾性分析417例初诊鼻咽癌患者的血浆EB病毒(EBV)-DNA检测结果,评估血浆EBV-DNA水平对鼻咽癌的辅助诊断价值以及与TNM分期的关系.方法 以2013年8月-2015年8月间在中山市人民医院肿瘤科住院的初诊鼻咽癌患者417例为研究对象,同时选取95例鼻咽炎症及健康人群211例为对照,抽取外周血分离血浆,提取EBV-DNA,采用定量PCR方法测定EBV-DNA水平.分析初诊鼻咽癌的EBV-DNA阳性检出率及其与TNM分期的关系.结果 初诊鼻咽癌患者EBV-DNA总阳性检出率为82.97%.临床早期(Ⅰ期+Ⅱ期)EBV-DNA阳性检出率只有61.00%,临床中晚期(Ⅲ期+Ⅳ期)可达到89.91%.Ⅰ期+Ⅱ期EBV-DNA含量低于Ⅲ期+Ⅳ期(P<0.01).T1期、T2期与T3期、T4期比较,EBV-DNA含量差异也具有统计学意义(P<0.01).N0期、N1期和N2期之间EBV-DNA中位值并无明显差异,而前三者中位值则显著低于N3期中位值(P<0.05).M0期和M1期的EBV-DNA中位值之间差异有统计学意义(P<0.05).结论 血浆EBV-DNA水平与鼻咽癌临床分期密切相关,可作为鼻咽癌诊断和临床分期的分子指标.%Objective To retrospectively analyze plasma EBV-DNA in 417 patients with newly diagnosed nasopharyngeal carcinoma (NPC) and to evaluate the value of plasma EBV-DNA for supplementary diagnosis of nasopharyngeal carcinoma and the relationship between EBV-DNA and TNM staging.Methods A total of 417 newly diagnosed NPC patients hospitalized at Zhongshan People's Hospital from August 2013 to August 2015 were enrolled in this study.At the same time, 95 cases of nasopharyngeal inflammation and 211 healthy individuals were selected as controls.Peripheral blood was drawn for isolating plasma, and EBV-DNA was extracted.The level of EBV-DNA was determined by quantitative PCR.An analysis of detection rate of positive-EBV-DNA in newly diagnosed nasopharyngeal carcinoma and its relationship with TNM staging was done.Results The total detection rate of positive-EBV-DNA in patients with newly diagnosed nasopharyngeal carcinoma was 82.97%.The detection rate of positive-EBV-DNA of clinical early stage (stageⅠ+stageⅡ) nasopharyngeal carcinoma was only 61.00%, while the detection rate of positive-EBV-DNA of clinical moderate late stage (stageⅢ+ stageⅣ) nasopharyngeal carcinoma reached to 89.91%.The content of EBV-DNA at stagesⅠand Ⅱ was significantly lower than that at stages Ⅲ and Ⅳ (P<0.01).Compared the content of EBV-DNA at stages T1 and T2 with that at stages T3 and T4, there were statistically significant differences (P<0.01).There was no significant difference in EBV-DNA median value among stages N0, N1 and N2, while the median value of the first three stages were significantly lower than that of stage N3 (P<0.05).Comparison of the EBV-DNA median value between stage M0 and stage M1 showed that there was also statistical difference (P<0.05).Conclusion Plasma EBV-DNA level is closely related to clinical staging of nasopharyngeal carcinoma and can be used as a molecular marker for diagnosis and clinical staging of nasopharyngeal carcinoma.