血浆爱泼斯坦-巴尔病毒DNA用于预测非角化性分化型鼻咽癌的治疗反应和疾病进展

Plasma Epstein-Barr virus DNA for the prediction of treatment response and disease progression in non-keratinizing differentiated nasopharyngeal carcinoma.

作者信息

Lu Guan-Zhong, Huang Yun-Xia, Guo Lin-Feng, Yu Yi-Feng, Lu Zhen-Zhen, Lin Qin, Wu San-Gang

机构信息

Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, School of Medicine, the First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, People's Republic of China.

出版信息

Infect Agent Cancer. 2025 May 20;20(1):30. doi: 10.1186/s13027-025-00661-3.

DOI:10.1186/s13027-025-00661-3

PMID:40394615

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12090694/

Abstract

PURPOSE

To explore the failure patterns, outcomes, and treatment response of differentiated non-keratinizing nasopharyngeal carcinoma (DNKC) and to further investigate the role of plasma Epstein-Barr virus (EBV)-DNA in follow-up monitoring, prognostic prediction, and assessment of treatment efficacy in DNKC.

METHODS

We retrospectively collected data from patients diagnosed with DNKC from January 2015 to February 2022. The life-table method, Kaplan-Meier survival, and Cox proportional hazards analysis were used for statistical analyses.

RESULTS

A total of 102 patients were included. Of the 77 patients with available EBV-DNA levels, 61 patients (79.2%) had EBV-DNA detectable before treatment. Twenty-seven patients (26.5%) experienced disease recurrence, and 88.9% (24/27) relapsed in the first three years. There were 20 patients who experienced disease recurrence and had pre-treatment EBV-DNA status records. At the time of disease progression, 4 patients initially had undetectable EBV-DNA remained undetectable. Among the 16 patients with initially detectable EBV-DNA, 15 (93.8%) had detectable EBV-DNA. Nodal stage and EBV-DNA levels before treatment were found to be independent prognostic factors for distant metastasis-free survival (DMFS) and disease-free survival (DFS). Those with residual EBV-DNA after induction chemotherapy had significantly inferior DMFS (P = 0.003), DFS (P = 0.006), and overall survival (OS) (P = 0.006) than those without residual EBV-DNA after IC. Those with residual EBV-DNA after radiotherapy had significantly inferior local recurrence-free survival (P = 0.003), DMFS (P < 0.001), DFS (P < 0.001), OS (P < 0.006) than those without residual EBV-DNA after radiotherapy.

CONCLUSION

Our study highlights the aggressive nature of DNKC, characterized by early recurrence. EBV-DNA levels may serve as a biomarker to monitor treatment response, prognostic prediction, and recurrence surveillance.

摘要

目的

探讨分化型非角化性鼻咽癌（DNKC）的失败模式、结局及治疗反应，并进一步研究血浆EB病毒（EBV）-DNA在DNKC随访监测、预后预测及治疗疗效评估中的作用。

方法

我们回顾性收集了2015年1月至2022年2月期间诊断为DNKC的患者的数据。采用寿命表法、Kaplan-Meier生存分析和Cox比例风险分析进行统计分析。

结果

共纳入102例患者。在77例有可用EBV-DNA水平的患者中，61例（79.2%）在治疗前可检测到EBV-DNA。27例（26.5%）患者出现疾病复发，88.9%（24/27）在前三年复发。有20例患者出现疾病复发且有治疗前EBV-DNA状态记录。在疾病进展时，4例最初EBV-DNA检测不到的患者仍检测不到。在16例最初EBV-DNA可检测到的患者中，15例（93.8%）EBV-DNA仍可检测到。治疗前的淋巴结分期和EBV-DNA水平被发现是无远处转移生存期（DMFS）和无病生存期（DFS）的独立预后因素。诱导化疗后有残留EBV-DNA的患者的DMFS（P = 0.003）、DFS（P = 0.006）和总生存期（OS）（P = 0.006）显著低于诱导化疗后无残留EBV-DNA的患者。放疗后有残留EBV-DNA的患者的无局部复发生存期（P = 0.003）、DMFS（P < 0.001）、DFS（P < 0.001）、OS（P < 0.006）显著低于放疗后无残留EBV-DNA的患者。