Laboratory markers of tumor burden in nasopharyngeal carcinoma: A comparison of viral load and serologic tests for Epstein-Barr virus
Laboratory markers of tumor burden in nasopharyngeal carcinoma: A comparison of viral load and serologic tests for Epstein-Barr virus
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DOI：
10.1002/ijc.20520
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发表时间：
2004-12-20
影响因子：
6.4
通讯作者：
Gulley, ML
中科院分区：
文献类型：
--
作者：
Fan, HX;Nicholls, J;Gulley, ML
EB病毒(EBV)存在于大多数鼻咽癌(NPC)的肿瘤细胞内。最近的研究表明，肿瘤负担与血液中EBV DNA水平成正比，快速血液检测可以用于指导治疗干预。病毒载量与血清学之间的相对效用尚未得到充分研究。在我们的研究中，用实时或终点检测系统用定量聚合酶链式反应检测了124例鼻咽癌患者(93例治疗前，13例复发，18例缓解期)和40例对照组的EBV病毒载量。在相同的血清样本中检测EBV早期抗原的血清学滴度。93例初治鼻咽癌患者(69%，平均病毒载量11,211拷贝/ml)、13例复发鼻咽癌患者中11例(85%，平均53,039拷贝/ml)和18例缓解期鼻咽癌患者(0)均检出EBVDNA。在40例非鼻咽癌对照中，仅1例(3%)可检测到EBV DNA。在34个可供检测的配对血浆和血清样本中，两者都是有效的样本类型，终点方法和实时方法在测量病毒载量方面没有显著差异。无论是活动期还是缓解期，大多数鼻咽癌患者早期抗原(EA)、IgA和Ig G滴度均升高。在区分缓解和复发疾病方面，EBV病毒载量比EA血清学更具信息量。EBVDNA测量似乎是监测治疗后肿瘤负担的一种非侵入性方法。(C)2004年Wiley-Liss公司
Epstein-Barr virus (EBV) is present within the tumor cells of most cases of nasopharyngeal carcinoma (NPC). Recent studies suggest that tumor burden is proportional to the level of EBV DNA in blood and that rapid blood testing can be used to guide therapeutic intervention. The relative utility of viral load vs. serology has been insufficiently studied. In our study, EBV viral load was measured by quantitative PCR using either real-time or end-point detection systems in serum samples from 124 NPC patients (93 pretreatment, 13 relapsed, 18 in remission) and 40 controls. Serologic titers against EBV early antigen were measured in the same serum samples. EBV DNA was detectable in 64 of 93 untreated NPC patients (69%; mean viral load 11,211 copies/ml), 11 of 13 relapsed NPC patients (85%; mean 53,039 copies/ml) and 0 of 18 remission patients. EBV DNA was detectable in only 1 of 40 non-NPC controls (3%). In 34 instances where paired plasma and serum samples were available for testing, both were effective sample types, and there was no significant difference between end-point and real-time methods for measuring viral load. Early antigen (EA) IgA and IgG titers were elevated in most NPC patients regardless of whether their disease was active or in remission. EBV viral load was more informative than was EA serology for distinguishing remission from relapsed disease. EBV DNA measurement appears to be a noninvasive way to monitor tumor burden after therapy. (C) 2004 Wiley-Liss, Inc.