Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China.
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China.
Oral Oncol. 2014 Jun;50(6):527-38. doi: 10.1016/j.oraloncology.2013.12.011. Epub 2014 Jan 15.
Elevated levels of circulating cell-free Epstein-Barr virus (EBV) DNA have been detected in plasma and serum samples from nasopharyngeal cancer (NPC) patients by quantitative real time PCR (qPCR) test. This qPCR test for circulating EBV DNA was found to be useful in the clinical management of NPC patients. For instance, EBV DNA qPCR test has good sensitivity and specificity in the detection of NPC at disease onset. Increase of the viral DNA load was found in NPC patients at late stages of disease. High EBV DNA load at disease onset or detectable viral load post-treatment was associated with poor survival or frequent relapse in NPC patients. Residual EBV DNA load after primary treatment could be a useful indicator to justify adjuvant chemotherapy. The qPCR test might also be applied to define a poor prognostic group in patients at early stage (I/II) for implementing concurrent chemo-radiotherapy (chemo-RT) to improve patients' outcome. The test is also useful to monitor distant metastases or response to radiotherapy, chemo-RT or surgery. Supplementary tests, however, are needed to pick up EBV negative WHO type I NPC and test improvement is needed to increase sensitivity in detecting stage I disease and local recurrence.
通过定量实时 PCR（qPCR）检测，已在血浆和血清样本中检测到鼻咽癌（NPC）患者循环无细胞 Epstein-Barr 病毒（EBV）DNA 水平升高。该循环 EBV DNA 的 qPCR 检测被发现对 NPC 患者的临床管理有用。例如，EBV DNA qPCR 检测在疾病发病时对 NPC 的检测具有良好的灵敏度和特异性。在疾病晚期，NPC 患者的病毒 DNA 载量增加。在 NPC 患者中，疾病发病时 EBV DNA 载量升高或治疗后可检测到病毒载量与生存不良或频繁复发相关。初次治疗后残留的 EBV DNA 载量可作为辅助化疗的合理指标。qPCR 检测也可用于定义早期（I/II 期）患者的预后不良组，以实施同期放化疗（chemo-RT）以改善患者预后。该检测还可用于监测远处转移或对放疗、chemo-RT 或手术的反应。然而，需要补充检测来发现 EBV 阴性的 WHO 1 型 NPC，并且需要提高检测灵敏度以检测 I 期疾病和局部复发。
