Long-term prognostic effects of plasma Epstein-Barr virus DNA by minor groove binder-probe real-time quantitative PCR on nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy
Long-term prognostic effects of plasma Epstein-Barr virus DNA by minor groove binder-probe real-time quantitative PCR on nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy
复制标题
DOI：
10.1016/j.ijrobp.2007.02.012
复制
发表时间：
2007-08-01
影响因子：
7
通讯作者：
Shen, Wu-Chung
中科院分区：
文献类型：
--
作者：
Lin, Jin-Ching;Wang, Wen-Yi;Shen, Wu-Chung
目的：评价实时定量聚合酶链反应（RTQ-PCR）检测鼻咽癌（NPC）患者同步放化疗（CCRT）后血浆EB病毒（EBV）DNA浓度对预后的长期影响。方法和材料：采用RTQ-PCR方法，对152例hko-psy-provenNPC患者的血浆进行回顾性检测，PCR使用小沟结合探针。所有患者均接受了CCRT，中位随访时间为78个月。我们将患者分为三个亚组：（1）低预处理EBV DNA（<1，500拷贝/mL）和不可检测的治疗后EBV DNA（前-L/后-U），（2）高预处理EBV DNA（>= 1，500拷贝/mL）和不可检测的治疗后EBV DNA（前H/后U），和（3）低或高的治疗前EBV DNA和可检测的治疗后EBV DNA（pre-L或Wpost-D）用于预后分析。在94.1%（143/152）的患者治疗前血浆中检测到了（中位浓度，573拷贝/mL;四分位数范围，197- 3，074）。治疗后，所有患者的血浆EBV DNA均降低或保持为0，31例患者（20.4%）可检出，中位浓度为0拷贝/mL（四分位距，0-0）。前L/后U、前H/后U和前L或H/后D亚组的5年总生存率分别为87.2%、71.0%和38.7%（p < 0.0001）。无复发生存率分别为85.6%、75.9%和26.9%（P < 0.0001）。多因素考克斯分析证实血浆EBV DNA在预测鼻咽癌预后方面上级其他临床指标。对于CCRT后持续检测到EBV DNA的患者，应考虑更多的化疗。(c)2007年爱思唯尔公司
Purpose: To evaluate the long-term prognostic impact of plasma Epstein-Barr virus (EBV) DNA concentration measured by real-time quantitative polymerase chain reaction (RTQ-PCR) in nasopharyngeal carcinoma (NPC) patients receiving concurrent chemoradiotherapy (CCRT).Methods and Materials: Epstein-Barr virus DNA was retrospectively measured from stock plasma of 152 hko-psy-provenNPC patients with Stage II-IV (MO) disease with a RTQ-PCR using the minor groove binderprobe. All patients received CCRT with a median follow-up of 78 months. We divided patients into three subgroups: (1) low pretreatment EBV DNA (< 1,500 copies/mL) and undetectable posttreatment EBV DNA (pre-L/post-U), (2) high pretreatment EBV DNA (>= 1,500 copies/mL) and undetectable posttreatment EBV DNA (pre-H/post-U), and (3) low or high pretreatment EBV DNA and detectable posttreatment EBV DNA (pre-L or Wpost-D) for prognostic analyses.Results: Epstein-Barr virus DNA (median concentration, 573 copies/mL; interquartile range, 197-3,074) was detected in the pretreatment plasma of 94.1% (143/152) of patients. After treatment, plasma EBV DNA decreased or remained 0 for all patients and was detectable in 31 patients (20.4%) with a median concentration 0 copy/mL (interquartile range, 0-0). The 5-year overall survival rates of the pre-L/post-U, pre-H/post-U, and pre-L or H/post-D subgroups were 87.2%, 71.0%, and 38.7%, respectively (p < 0.0001). The relapse-free survival showed similar results with corresponding rates of 85.6%,75.9%, and 26.9%, respectively (p < 0.0001). Multivariate Cox analysis confirmed the superior effects of plasma EBV DNA compared to other clinical parameters in prognosis prediction.Conclusion: Plasma EBV DNA is the most valuable prognostic factor for NPC. More chemotherapy should be considered for patients with persistently detectable EBV DNA after CCRT. (c) 2007 Elsevier Inc.