【摘要】：目的：動(dòng)態(tài)檢測(cè)鼻咽癌患者放療前后血清EBV VCA-IgA和EA-IgA抗體效價(jià)及外周血單個(gè)核細(xì)胞EBV DNA載量的變化,探討血清中EBV DNA載量及抗體效價(jià)變化在鼻咽癌療效監(jiān)測(cè)及預(yù)后評(píng)估中的意義。 方法：選擇24例鼻咽癌患者作為研究對(duì)象,EBER1原位雜交篩選出EBV陽性患者,收集EBV陽性患者放療前、放療過程中及放療結(jié)束后的血清及外周血單個(gè)核細(xì)胞標(biāo)本；采用ELISA試劑盒和實(shí)時(shí)熒光定量PCR動(dòng)態(tài)檢測(cè)患者血清VCA-IgA和EA-IgA抗體效價(jià),以及外周血單個(gè)核細(xì)胞EBV DNA載量,分析隨放療的進(jìn)行EBV特異性抗體及EBV DNA載量的變化。 結(jié)果：①22例鼻咽癌病人血清VCA-IgA、 EA-IgA抗體和EBV DNA在3個(gè)不同放療階段之間的差異均有統(tǒng)計(jì)學(xué)意義(F=3.305,8.914,9.461,P0.05)。放療結(jié)束后VCA-IgA抗體水平顯著低于放療前水平(t=2.081,P0.05),而放療中與放療前及放療結(jié)束后比較差異均無顯著性(t=0.33,0.47,P0.05)。②EA-IgA抗體水平在放療結(jié)束后顯著低于放療前,而放療前與放療中及放療后比較差異均無統(tǒng)計(jì)學(xué)意義(t=0.606,0.50,P0.05)。③7例病人從治療開始至治療結(jié)束均未檢測(cè)到EBV DNA,其余15例病人EBV DNA載量放療前與放中及放療結(jié)束后比較差異均有顯著性(t=2.47、4.34,P0.05),而放療中和放療結(jié)束后比較差異無顯著性(t=-1.86,P0.05)。 結(jié)論：①動(dòng)態(tài)觀察鼻咽癌患者EBV VCA-IgA和EA-IgA抗體效價(jià)以及外周血EBV DNA載量變化對(duì)評(píng)估鼻咽癌療效均具有實(shí)用價(jià)值,其中EBV DNA載量變化較VCA-IgA和EA-IgA抗體效價(jià)變化更為敏感。②動(dòng)態(tài)觀察EBV DNA載量變化在鼻咽癌療效監(jiān)測(cè)方面的價(jià)值明顯優(yōu)于VCA-IgA及EA-IgA抗體檢測(cè),EBV DNA載量和特異性抗體的聯(lián)合檢測(cè)、綜合分析有助于客觀評(píng)價(jià)鼻咽癌患者放療效果和預(yù)測(cè)患者預(yù)后。
[Abstract]:Objective: to investigate the changes of serum EBV VCA-IgA and EA-IgA antibody titers and the EBV DNA load of peripheral blood mononuclear cells (PBMC) in patients with nasopharyngeal carcinoma before and after radiotherapy. To investigate the significance of serum EBV DNA load and antibody titer in monitoring the curative effect and evaluating prognosis of nasopharyngeal carcinoma (NPC). Methods: 24 patients with nasopharyngeal carcinoma were selected and EBV positive patients were screened by EBER1 in situ hybridization. The samples of serum and peripheral blood mononuclear cells were collected from EBV positive patients before, during and after radiotherapy. The serum VCA-IgA and EA-IgA antibody titers and the EBV DNA load of peripheral blood mononuclear cells (PBMC) were detected by ELISA kit and real-time fluorescence quantitative PCR. The changes of EBV specific antibody and EBV DNA load with radiotherapy were analyzed. Results: there were significant differences in serum VCA-IgA, EA-IgA antibody and EBV DNA between patients with nasopharyngeal carcinoma in three different radiotherapy stages (FF3. 305, 8. 914, 9. 461 P 0.05). The level of VCA-IgA antibody after radiotherapy was significantly lower than that before radiotherapy (t = 2.081p0.05), but there was no significant difference between radiotherapy and after radiotherapy (t = 0.33 鹵0.47, P < 0.05). The level of 2EA-IgA antibody after radiotherapy was significantly lower than that before radiotherapy, but there was no significant difference between before and after radiotherapy (t = 0.606 鹵0.50, P < 0.05). From the beginning of treatment to the end of treatment, no EBV DNA, was detected in the other 15 patients. There was significant difference in EBV DNA load before radiotherapy and after radiotherapy in 37 patients (t = 2.47 or 4.34 P 0.05). However, there was no significant difference after radiotherapy and radiotherapy (tr-1.86 P 0.05). Conclusion: 1 dynamic observation of the antibody titers of EBV VCA-IgA and EA-IgA and the changes of EBV DNA load in peripheral blood of patients with nasopharyngeal carcinoma have practical value in evaluating the curative effect of nasopharyngeal carcinoma. The change of EBV DNA load was more sensitive than that of VCA-IgA and EA-IgA antibody titers. 2 the value of dynamic observation of EBV DNA load in monitoring the curative effect of nasopharyngeal carcinoma was significantly better than that of VCA-IgA and EA-IgA antibody detection. The combined detection of EBV DNA load and specific antibody is helpful to evaluate the radiotherapy effect and predict the prognosis of nasopharyngeal carcinoma patients.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R739.63

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前1條

1 阮開安;鼻咽癌放療后局部復(fù)發(fā)的影像學(xué)分析[D];廣西醫(yī)科大學(xué);2013年

，

本文編號(hào)：2376279