结合血浆爱泼斯坦-巴尔病毒DNA和18F-氟-2-脱氧-D-葡萄糖正电子发射断层扫描的淋巴结最大标准摄取值，可改善预后分层，以预测局部晚期鼻咽癌的远处转移。

Combining plasma Epstein-Barr virus DNA and nodal maximal standard uptake values of 18F-fluoro-2-deoxy-D-glucose positron emission tomography improved prognostic stratification to predict distant metastasis for locoregionally advanced nasopharyngeal carcinoma.

作者信息

Chen Wen-Hui, Tang Lin-Quan, Zhang Lu, Chen Qiu-Yan, Guo Shan-Shan, Liu Li-Ting, Fan Wei, Zhang Xu, Guo Ling, Zhao Chong, Cao Ka-Jia, Qian Chao-Nan, Guo Xiang, Xie Dan, Zeng Mu-Sheng, Mai Hai-Qiang

机构信息

Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.

Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.

出版信息

Oncotarget. 2015 Nov 10;6(35):38296-307. doi: 10.18632/oncotarget.5699.

BACKGROUND

This study aimed to evaluate the value of combining the nodal maximal standard uptake values (SUVmax) of (18) F-fluoro-2-deoxy-D-glucose positron emission tomography with Epstein-Barr virus DNA(EBV DNA) levels to predict distant metastasis for nasopharyngeal carcinoma (NPC) patients.

PATIENTS AND METHODS

Eight hundred seventy-four patients with stage III-IVa-b NPC were evaluated for the effects of combining SUVmax and EBV DNA levels on distant metastasis-free survival (DMFS), disease-free survival (DFS) and overall survival (OS).

RESULTS

The optimal cutoff value was 6,220 copies/mL for EBV DNA and 7.5 for SUVmax-N. Patients with lower EBV DNA levels or SUVmax-N had a significantly better 3-year DMFS, DFS, and OS. Patients were divided into four groups based on EBV DNA and SUVmax-N, as follows: low EBV DNA and low SUVmax-N (LL), low EBV DNA and high SUVmax-N (LH), high EBV DNA and low SUVmax-N (HL), and high EBV DNA and high SUVmax-N (HH). There were significant differences between the four mentioned groups in 3-year DMFS: 95.7%, 92.2%, 92.3%, and 80.1%, respectively (P(trend) < 0.001). When looking at the disease stage, the 3-year DMFS in group LL, LH, HL, HH were 94.2%, 92.9%, 95.0%, and 81.1%, respectively, in stage III patients (P(trend) < 0.001) and 92.7%, 87.2%, 86.3%, and 77.0% in stage IVa-b patients (P(trend) = 0.026).

CONCLUSION

Pretreatment EBV DNA and SUVmax of neck lymph nodes were independent prognostic factors for distant metastasis in NPC patients. Combining EBV DNA and SUVmax-N led to an improved risk stratification for distant metastasis in advanced-stage disease.

背景

本研究旨在评估¹⁸F-氟-2-脱氧-D-葡萄糖正电子发射断层显像的淋巴结最大标准摄取值（SUVmax）与爱泼斯坦-巴尔病毒DNA（EBV DNA）水平相结合对鼻咽癌（NPC）患者远处转移的预测价值。

患者与方法

对874例III-IVa-b期NPC患者评估SUVmax与EBV DNA水平相结合对无远处转移生存期（DMFS）、无病生存期（DFS）和总生存期（OS）的影响。

结果

EBV DNA的最佳截断值为6220拷贝/mL，SUVmax-N的最佳截断值为7.5。EBV DNA水平或SUVmax-N较低的患者3年DMFS、DFS和OS显著更好。根据EBV DNA和SUVmax-N将患者分为四组，如下：低EBV DNA和低SUVmax-N（LL）、低EBV DNA和高SUVmax-N（LH）、高EBV DNA和低SUVmax-N（HL）以及高EBV DNA和高SUVmax-N（HH）。上述四组的3年DMFS存在显著差异：分别为95.7%、92.2%、92.3%和80.1%（P趋势<0.001）。在疾病分期方面，III期患者中LL、LH、HL、HH组的3年DMFS分别为94.2%、92.9%、95.0%和81.1%（P趋势<0.001），IVa-b期患者中分别为92.7%、87.2%、86.3%和77.0%（P趋势=0.026）。