摘要
目的：探讨同期放化疗对晚期鼻咽癌患者血浆EB病毒DNA水平的影响。方法选取98例晚期鼻咽癌患者作为研究对象，采用放疗联合紫杉醇化疗进行治疗，并对98例患者血浆EBV-DNA 水平采用荧光定量PCR 技术进行测定，并与其影像学检查及病理结果进行比较分析。结果放化疗后鼻咽癌患者52例缓解，21例稳定，25例进展。三组鼻咽癌患者血浆EB-DNA水平测定阳性率缓解组为0、稳定组为4．76％，进展组最高为88．00％，缓解组与稳定组比较，差异无统计学意义（P＞0．05），进展组分别与缓解组、稳定组比较，差异均具有统计学意义（P＜0．05）；3组敏感性分别为0、4．76％、88．00％，特异性分别为100．00％、95．24％、12．00％，阴性预测值分别为69．33％、26．67％、4．00％，阳性预测值分别为0、4．35％、95．65％；缓解组特异性和阴性预测值最高，与进展组比较，差异有统计学意义（ P＜0．05）；进展组敏感性和阳性预测值最高，与缓解组和稳定组比较，差异有统计学意义（P＜0．05）。结论晚期鼻咽癌患者同期放化疗后血浆EB病毒DNA水平，可作为监测和反映鼻咽癌患者放化疗后转移、复发的重要指标。
Abstract
Objective To investigate the effect of concurrent chemoradiotherapy for EB virus DNA levels in plasma of patients with advanced nasopharyngeal carcinoma .Methods 98 patients with advanced nasopharyngeal carcinoma received radia-tion therapy combined with paclitaxel chemotherapy , and plasma EBV-DNA level of 98 patients were measured by quantitative PCR and was compared with imaging and pathology results .Results After chemoradiotherapy ,there were 52 cases of remission , 21 cases of stable and 25 cases of progress.Positive rate of plasma EB-DNA level in remission group was 0,stable group was 4.76%,progressive group was 88.00%,the difference was not statistically significant between remission group and stable group (P>0.05),progress group were compared with remission group and stable group ,the difference was statistically significant (P<0.05);sensitivity of the 3 groups were 0,4.76%,88.00%,specificity were 100.00%,95.24%,12.00%,and negative predic-tive values were 69.33%,26.67%,4.00%,positive predictive value were 0,4.35%,95.65%;remission group had the highest specificity and negative predictive value,compared with the progress group,the difference was statistically significant(P<0.05);the progress group had the highest sensitivity and positive predictive value ,compared with remission group and stable group ,the difference was statistically significant (P<0.05).Conclusion EB virus DNA levels in plasma of patients with advanced naso-pharyngeal carcinoma after concurrent chemoradiotherapy can be used as an important indicator in surveillance and reflect of me -tastasis and recurrence .
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