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目的探讨鼻咽癌患者在放疗过程中外周血EBVDNA水平的动态变化规律及与临床疗效的关系。方法运用荧光定量PCR技术动态检测44例鼻咽癌患者放疗期间血浆EBVDNA水平,放疗期间每周的第1天检测1次;临床观察放疗过程中鼻咽部肿瘤消退情况与外周血EBVDNA水平变化的关系。结果放疗完成2周时,血浆EBVDNA阳性率及拷贝数较前显著下降,其余各周之间阳性率及拷贝数均无明显差异。放疗过程中血浆EBVDNAA水平变化表现为三种动力学曲线形式。每周临床观察鼻咽肿块消退情况发现:随着放疗剂量增加,鼻咽肿块逐渐缩小,血浆EBVDNA水平逐渐下降。结论放疗过程中血浆EBVDNA水平变化与鼻咽癌患者临床疗效关系密切,同时有可能成为监测鼻咽癌患者放疗后复发、转移的肿瘤标记物。
Objective To investigate the dynamic changes of EBV DNA levels in peripheral blood of patients with nasopharyngeal carcinoma during radiotherapy and its relationship with clinical efficacy. Methods Fluorescence quantitative PCR was used to detect plasma EBV levels in 44 patients with nasopharyngeal carcinoma (NPC) during radiotherapy and detected on the first day of the week during radiotherapy. The changes of nasopharyngeal tumor regression and EBV DNA levels in peripheral blood during radiotherapy were observed clinically relationship. Results At the end of 2 weeks after radiotherapy, the positive rate of EBV DNA and the copy number of plasma decreased significantly compared with those before. There was no significant difference in the positive rate and copy number between the other weeks. Plasma EBVDNAA levels during radiotherapy showed three kinetic curves. Weekly clinical observation nasopharyngeal mass regression found that: with the increase of radiotherapy dose, nasopharyngeal mass gradually reduced, plasma EBVDNA levels decreased. Conclusions The change of plasma EBV DNA level during radiotherapy is closely related to the clinical efficacy of nasopharyngeal carcinoma patients. It may also become a tumor marker for monitoring the recurrence and metastasis of patients with nasopharyngeal carcinoma after radiotherapy.