摘要
目的 分析治疗前全血EB病毒DNA载量检测与行根治性治疗的Ⅲ期鼻咽癌患者治疗效果评估及预后判断的相关性.方法 选取180例接受了根治性治疗的Ⅲ期鼻咽癌患者作为研究对象,根据治疗前全血EB病毒DNA载量水平是否高于1000拷贝/mL将其分为高病毒载量组(n=54)和低病毒载量组(n=126).两组患者均接受调强放疗治疗和类药物参与的诱导或辅助化疗,患者在入院次日接受治疗前进行全血EB病毒DNA载量检测,比较两组患者的总生存期(OS)、无进展生存期(PFS)、无局部复发生存期(LR-RFS)和无远处转移生存期(DMFS)占比及绘制ROC曲线分析治疗前全血EB病毒DNA载量检测对Ⅲ期鼻咽癌患者的预后判断价值.结果 180例首治Ⅲ期鼻咽癌患者的5年OS、PFS、LR-RFS和DMFS占比分别为83.52％、72.50％、78.62％和78.15％.低载量病毒组患者的5年OS、PFS、LR-RFS和DMFS占比明显高于高载量病毒组,组间比较具有统计学意义(P＜0.05).绘制ROC曲线发现:治疗前全血EB病毒DNA载量检测对Ⅲ期鼻咽癌患者进行预后判断的曲线下面积(AUC)为0.905,敏感度和特异度分别为85.28％和92.25％.结论 EB病毒DNA载量与患者治疗效果和预后相关,对于高载量患者应当加强随访和及时治疗以挽救患者生命.
Abstract
Objective To analyze the correlation between the detection of EB virus DNA load in whole blood before treatment and the evaluation of treatment effect and prognosis of patients with stage Ⅲ nasopharyngeal carcinoma undergoing radical treatment.Methods 180 patients with stage Ⅲ nasopharyngeal carcinoma who received radical treatment were selected as the research objects.According to whether the whole blood EB virus DNA load level was higher than 1000 copies/mL before treatment,they were divided into high viral load group(n=54)and low viral load group(n=126).Both groups of patients received intensity-modulated radiotherapy and induction or adjuvant chemotherapy involving drugs,where the patients were tested for EB virus DNA load in whole blood before treatment on the next day after admission.The overall survival(OS),progression free survival(PFS)and the proportion of local recurrence free survival(LR-RFS)and distant metastasis free survival(DMFS)of the two groups were compared and the ROC curve were drawn to analyze the prognostic value of EB virus DNA load in whole blood before treatment in patients with stageⅢ nasopharyngeal carcinoma.Results The 5-year OS,PFS,LR-RFS and DMFS accounted for 83.52％,72.50％,78.62％and 78.15％respectively in 180 patients with stage Ⅲ nasopharyngeal carcinoma.The proportion of OS,PFS,LR-RFS and DMFS in the low load virus group was significantly higher than that in the high load virus group,and the comparison between groups was statistically significant(P＜0.05).The ROC curve showed that the area under the curve(AUC)of EB virus DNA load in whole blood before treatment was 0.905,and the sensitivity and specificity were 85.28％and 92.25％respectively.Conclusions EB virus DNA load is related to the treatment effect and prognosis of patients.,which for patients with high load,follow-up and timely treatment should be strengthened to save the lives of patients.
NETL
NSTL
维普
万方数据