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[目的]探讨EB病毒与鼻咽癌淋巴结转移的关系。[方法]收集首诊鼻咽癌患者721例,按“中国鼻咽癌2008TNM分期”标准对咽后淋巴结及颈部淋巴结转移进行判断,分别计算咽后淋巴结阴阳性与颈部淋巴结阴阳性的病例数;使用PCR检测法对病例进行治疗前血浆EBV-DNA检测,以及记录每个病例EBV-DNA拷贝数。[结果]鼻咽癌患者咽后淋巴结转移者有较高的颈部淋巴结转移率,差异有统计学意义(P=0.013),Pearson关联系数,r=0.342,P=0.000,有统计学意义;双侧咽后淋巴结转移较单侧转移者有较高的颈部淋巴结转移率,差异有显著统计学意义(P=0.001);咽后淋巴结与颈部淋巴结均有转移者较其他病例组有较高的EBV-DNA拷贝数,差异有显著统计学意义(P=0.000)。[结论]鼻咽癌患者咽后淋巴结转移与颈淋巴结转移有正相关关系,咽后淋巴结与颈部淋巴结均有转移者有较高的EBV-DNA拷贝数。推测EBV-DNA检测可作为评估鼻咽癌淋巴结转移的分子生物学指标之一。
[Objective] To explore the relationship between Epstein-Barr virus and lymph node metastasis in nasopharyngeal carcinoma. [Methods] 721 patients with first diagnosis of nasopharyngeal carcinoma were collected, and the lymph node metastasis of the retropharyngeal lymph nodes and cervical lymph node were judged according to the Chinese TNM staging system of Chinese nasopharyngeal carcinoma. The yin and pharyngeal lymph nodes were positive and the lymph nodes were positive and negative. The number of cases; plasma EBV-DNA detection before treatment using PCR detection methods, and the number of EBV-DNA copies in each case was recorded. [Results] The lymph node metastasis rate of patients with nasopharyngeal carcinoma in the retropharyngeal lymph node was higher than that in the control group (P=0.013). The Pearson correlation coefficient was r=0.342, P=0.000. Bilateral retropharyngeal lymph node metastasis had higher cervical lymph node metastasis rate than unilateral metastasis, with statistically significant difference (P=0.001); both retropharyngeal lymph nodes and cervical lymph node metastases were more common than other cases. The high EBV-DNA copy number was statistically significant (P=0.000). [Conclusion] There was a positive correlation between pharyngeal lymph node metastasis and cervical lymph node metastasis in patients with nasopharyngeal carcinoma. The EBV-DNA copy number was higher in patients with metastasis between pharyngeal lymph nodes and cervical lymph nodes. It is speculated that EBV-DNA detection can be used as one of the molecular biological markers for evaluating lymph node metastasis of nasopharyngeal carcinoma.