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。%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 .