首页 > 文章详情

血浆DNA分析在鼻咽癌筛查中的应用

2018年11月17日

编译：肿瘤资讯

来源：肿瘤资讯

血浆DNA分析在鼻咽癌筛查中的应用

K.C. Allen Chan

教授

香港中文大学

鼻咽癌（NPC）是香港地区最常见的癌症之一。早期鼻咽癌患者五年生存率超过95％，其治疗效果优于晚期患者。然而，因为早期鼻咽癌相对无症状，近80％的鼻咽癌患者确诊时为局部晚期或转移。K. C.Allen Chan等研究者利用Epstein-Barr病毒（EBV）感染与NPC之间的密切关系，开发了循环EBV DNA作为鼻咽癌的标记物。在2013年至2016年期间，他们使用敏感的血浆EBV DNA测定筛查了超过20,000名年龄在40至62岁之间的无症状男性。通过鼻内窥镜检查和MRI进一步诊断EBV DNA检测阳性的个体。34例患者最后被确诊为鼻咽癌。值得注意的是，几乎一半的鼻咽癌病例为I期。与历史队列相比，通过筛查诊断的鼻咽癌患者的无进展生存率大大提高，风险比为0.1。该研究证实循环DNA分析可用于筛查早期癌症。该技术可潜在地应用于检测其他非病毒相关癌症。

Screening For Nasopharyngeal Cancer By Plasma DNA Analysis

Nasopharyngeal carcinoma (NPC) is one of the commonest cancers in Hong Kong. Early-stage NPC patients had much better treatment outcomes than those with advanced disease, with a five-year survival of over 95%. However, almost 80% NPC patients present with locally advanced or metastatic disease because early NPC is relatively asymptomatic. Making use of the close relationship between Epstein-Barr virus (EBV) infection and NPC, Allen and his colleagues developed circulating EBV DNA as a marker for NPC. Using a sensitive plasma EBV DNA assay, they screened over 20,000 asymptomatic men with age 40 to 62 years for NPC from 2013 to 2016. Individuals with positive test results were further investigated with nasal endoscopy and MRI. Thirty-four cases of NPC were identified with this arrangement. Remarkably, almost half of the NPC cases had stage I disease. Compared with historical cohorts, NPC patients identified by screening had much improved progression-free survival with a hazard ratio of 0.1. Their study demonstrates that circulating DNA analysis can be used for screening early cancer. This technology can potentially be applied for the detection of other non-viral-related cancers.