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目的:探讨EB病毒DNA(EBV-DNA)在鼻咽癌放疗前后的动态变化及与复发、远处转移的关系。方法:采用PCR加限制性内切酶酶切技术检测EBV-DNA。结果:放疗前,74例标本中有71例(95.9%)EBV-DNA片段检出阳性;放疗50 Gy/5周时,23例鼻咽原发灶和颈部淋巴结消失,其阳性率为13.0%(3/23),余51例肿块未消者阳性率为62.7%(32/51);放疗至70 Gy/7周时,7例放疗后有残留,有残留者在放疗结束时EBV-DNA片段的检出阳性率为71.4%(5/7),在67例肿块消失者中未检出阳性EBV-DNA片段。12例复发者中,11例EBV-DNA片段检出阳性;8例转移者中EBV-DNA片段检出均为阳性。结论:检测血浆EBV-DNA能很好地反映肿瘤的消长,是诊断鼻咽癌残留、复发及远处转移的敏感指标。
Objective: To investigate the dynamic changes of Epstein-Barr virus DNA (EBV-DNA) before and after radiotherapy and its relationship with recurrence and distant metastasis. Methods: EBV-DNA was detected by PCR and restriction endonuclease digestion. Results: Before radiotherapy, EBV-DNA fragment was positive in 71 of 74 samples (95.9%). At the time of 50 Gy / 5 weeks radiotherapy, 23 cases of nasopharyngeal primary tumor and cervical lymph node disappeared, the positive rate was 13.0 % (3/23). The positive rate of untreated mass in 51 cases was 62.7% (32/51). After radiotherapy to 70 Gy / 7 weeks, 7 patients had residual after radiotherapy, and those with residual after EBV- The positive rate of DNA fragment was 71.4% (5/7). No positive EBV-DNA fragment was detected in 67 cases with disappearance of tumor mass. Of the 12 patients with recurrence, 11 were positive for EBV-DNA and 8 were EBV-DNA. Conclusion: Detecting plasma EBV-DNA can well reflect the growth and decline of tumor, and it is a sensitive index to diagnose nasopharyngeal carcinoma residual, recurrence and distant metastasis.