Li Yu-Hong, Shao Jian-Yong, Zhao Mei-Qing, Gao Hong-Yi, Li Li-Rong, Guan Zhong-Zheng, Zeng Yi-Xin
Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
Ai Zheng. 2003 Jun;22(6):645-8.
BACKGROUND & OBJECTIVE: Nasopharyngeal carcinoma (NPC) is closely related to Epstein-Barr virus (EBV) infection. Recently, it was reported that EBV DNA could be detected in the plasma or serum of NPC patients, but the clinical significance of EBV DNA concentration for monitoring of tumor recurrence and metastasis in NPC patients after radiotherapy has not been reported. This study was designed to quantitatively analyze the plasma EBV DNA concentration in NPC patients after radiotherapy, and to evaluate its application for monitoring of tumor recurrence and metastasis.
Ninety NPC outpatients after radiotherapy in Cancer Center, Sun Yat-sen University were followed up. The plasma EBV DNA were analyzed by using fluorescent quantitative PCR technique, and the quantity of plasma EBV DNA were compared between recurrent and clinical remission NPC patients.
Ninety-six point seven percent (29/30) of recurrent and metastatic patients were detectable for plasma EBV DNA, with median concentration of 2650 copies/ml (range:0-5900000), whereas only 12%(7/60) of the clinical remission patients were detectable for plasma EBV DNA, with median concentration of 0 copy/ml (range:0-71000). The detectable proportion and concentration in recurrent and metastatic NPC patients were significantly higher than that in clinical remission NPC patients (P< 0.01). Three of the clinical remission NPC patients with elevated EBV DNA copy were confirmed for tumor local recurrence or metastasis after further 3-4 month follow-up.
The results suggest that plasma EBV DNA detection may be a sensitive tumor marker for monitoring tumor recurrence and metastasis of NPC patients after radiotherapy.
鼻咽癌(NPC)与EB病毒(EBV)感染密切相关。近期有报道称可在NPC患者的血浆或血清中检测到EBV DNA,但EBV DNA浓度对放疗后NPC患者肿瘤复发和转移监测的临床意义尚未见报道。本研究旨在定量分析放疗后NPC患者血浆中EBV DNA浓度,并评估其在肿瘤复发和转移监测中的应用价值。
对中山大学肿瘤防治中心90例放疗后的NPC门诊患者进行随访。采用荧光定量PCR技术分析血浆EBV DNA,并比较复发和临床缓解的NPC患者血浆EBV DNA数量。
复发和转移患者中96.7%(29/30)可检测到血浆EBV DNA,中位浓度为2650拷贝/毫升(范围:0 - 5900000),而临床缓解患者中仅12%(7/60)可检测到血浆EBV DNA,中位浓度为0拷贝/毫升(范围:0 - 71000)。复发和转移的NPC患者的可检测比例和浓度显著高于临床缓解的NPC患者(P < 0.01)。3例EBV DNA拷贝数升高的临床缓解NPC患者在进一步随访3 - 4个月后被证实肿瘤局部复发或转移。
结果表明,血浆EBV DNA检测可能是监测放疗后NPC患者肿瘤复发和转移的敏感肿瘤标志物。