鼻咽癌患者血浆EBV DNA﹑ 血清CYFRA21-1 和VCA-IgA 检测及临床应用.docVIP

鼻咽癌患者血浆EBV DNA﹑血清CYFRA21-1和VCA-IgA的检测及临床应用 孙剑光1 王化修2 肖方庚1 刘亚林1 （1邵阳医学高等专科学校附属医院耳鼻喉科；2邵阳医学高等专科学校病理教研室；湖南 邵阳422000） 摘要 目的 探讨血浆EBV DNA、血清CYFRA21-1和VCA-IgA三种肿瘤标记物对鼻咽癌诊断、疗效监测和预后判断的临床应用价值。 方法 分别采用荧光定量PCR法、电化学发光法和免疫酶法检测62例鼻咽癌患者治疗前、后及62例健康对照者血浆EBV DNA、血清CYFRA21-1和VCA-IgA含量，并进行对比分析。 结果 治疗前组血浆EBV DNA、血清CYFRA21-1和VCA-IgA的阳性率明显高于健康对照组（P＜0.01）；治疗后组血浆EBV DNA、血清CYFRA21-1和VCA-IgA含量高者，在随访中发现肿瘤残存、复发或远处转移。 结论 血浆EBV DNA、血清CYFRA21-1和VCA-IgA的检测对鼻咽癌的早期诊断与高危人群的筛查、以及对鼻咽癌患者的疗效监测和预后判断有重要的临床应用价值，三种肿瘤标记物的联合检测有互补作用。 [关键词] 鼻咽癌；EB病毒；EBV DNA；CYFRA21-1；VCA-IgA Quantification and Clinical Application of Plasma Cell-free EBV DNA, Cerum CYFRA21-1 and VCA-IgA in Patients with Nasopharyngeal Carcinoma SUN Jian-guang1, WANG Hua-xiu2,XIAO Fang-geng1, LIU Ya-lin1 (1. Department of Otolaryngology, the Affilicated Hospital of Shaoyang Medical College; 2. Department of Pathology, Shaoyang Medical College,Shaoyang, Hunan 422000) Abstract: 【Objective】To investigate the role of plasma EBV DNA, serum CYFRA21-1and VCA-IgA in diagnosis, curative effect survey and prognosis of nasopharyngeal carcinoma patients(NPC). 【Methods】The plasma EBV DNA, serum CYFRA21-1 and VCA-IgA in 62 nasopharyngeal carcinoma patients and 62 healthy controls were analyzed using fluorescence quantitative polymerase chain reaction, electrochemiluminescence immunoassay, and immunoenzyme assay,respectively. 【Results】The positive rates and concentrations of plasma EBV DNA, serum CYFRA21-1 and VCA-IgA among new cases with NPC were significantly higher than those among healthy controls (P0.01). After the completion of treatment, the patients had significantly higher plasma EBV DNA and serum VCA-IgA concentration compared with patients who had not, the residual tumors, locoregional recurrence and distant metastasis. 【Conclusion】plasma EBV DNA, serum CYFRA21-1 and VCA-IgA detectin have important value in early diagnosis, screening of high risk population, curative effect survey and prognosis. The simultaneous combination tests can rise ad