"青"近英语|邱博士和您一起学-鼻咽癌篇

发布时间:2018-05-17     信息来源:     字号: T | T

邱素芳,主任医师,肿瘤学博士,副教授,硕士科研生导师。专业从事鼻咽癌、舌癌、口咽癌、下咽癌、喉癌、副鼻窦癌等头颈部恶性肿瘤的放化疗。兼任第八届中华医学会放射肿瘤学分会青年委员会副主任委员等。颁发国内外论文30余篇,其中SCI 10多篇。

We used nasopharyngeal carcinoma as a model to show the potential application of analysis of circulating DNA for cancer screening. Nasopharyngeal carcinoma is prevalent in Southeast Asia. Among middle-aged men, the incidence of nasopharyngeal carcinoma in endemic areas is up to 35 cases per 100,000 persons, and risk factors include a family history of nasopharyngeal carcinoma, consumption of salted fish, and smoking. The pathogenesis of nasopharyngeal carcinoma is closely associated with Epstein–Barr virus (EBV), and circulating cancer-derived EBV DNA in plasma has been established as a tumor marker for nasopharyngeal carcinoma, with a sensitivity of 96% and a specificity of 93%. EBV DNA in plasma consists of short DNA fragments (primarily <181 bp) that are released by nasopharyngeal carcinoma cells, rather than being associated with viral particles.

 

The extent of nasopharyngeal carcinoma at diagnosis is the most important factor affecting survival. The 5-year survival among patients with stage I disease is as high as 95%, whereas survival among patients with stage IV disease is just over 60%. Unfortunately, since early nasopharyngeal carcinoma is relatively asymptomatic, 80% of the patients with nasopharyngeal carcinoma present with locally advanced disease or distant metastasis at diagnosis. 

 

The identification of patients with early-stage nasopharyngeal carcinoma through screening could potentially improve treatment outcomes. Although anti-EBV IgA serologic tests are commonly performed to evaluate patients in whom nasopharyngeal carcinoma is suspected, there is little information on the use of these markers to screen for nasopharyngeal carcinoma in asymptomatic participants, possibly because of the low sensitivities and specificities of such markers. Proof-of-principle studies have shown that analysis of EBV DNA in plasma could potentially detect small asymptomatic nasopharyngeal carcinomas.

 


重点单词



1.nasopharyngeal[,neiz?uf?'rind?i?l]

adj. 鼻咽的

2.carcinoma [,kɑ?s?'n??m?]

n. [肿瘤

3.plasma ['pl?zm?]

n. [等离子等离子体;血浆;

4.endemic [en'dem?k]

adj. 地方性的;风土的

5.pathogenesis [,p?θ?(?)'d?en?s?s]

n. 发病机理;发病原

6.sensitivity [sens?'t?v?t?]

n. 敏感;敏感性;过敏

7.specificity[,spes?'f?s?t?]

n. [免疫特异性;特征;专一性

8.metastasis [m?'t?st?s?s]

n. 转移;新陈代谢;【地质】同质蜕变

       9.asymptomatic[?,s?mpt?'m?t?k; e?-]

       adj. 无症状的


重点词汇:

nasopharyngealcarcinoma 

鼻咽癌

Epstein–Barr virus(EBV)  EBV DNA

circulating DNA      

循环DNA

endemic areas       

流行区域

family history       

家族史

salted fish         

咸鱼

tumor marker       

肿瘤标志物

early-stage         

早期

locally advanceddisease   

局部晚期

       distant metastasis      

  远处转移


大家剖析血液中循环DNA对鼻咽癌的潜在筛选价值。鼻咽癌是中国南方及东南亚国家高发病种,中年男性好发,在鼻咽癌流行地区发病率为35/10万,危险因素包括鼻咽癌家族史,吃咸鱼及吸烟。鼻咽癌发病机制与Epstein-Barr病毒(EBV)感染密切相干。血浆中的EBV DNA已作为鼻咽癌的肿瘤标志物。其检测的敏感性为96%,特异性为93%。 EBV DNA首要检测血浆中短的DNA片段(<181 bp)。首要由鼻咽癌细胞释放。

鼻咽癌诊断时的病期早晚是影响预后最重要的因素。I期生存率可达95%,而IV期患者生存率仅为超过60%。但由于早期鼻咽癌症状不典型,80%的鼻咽癌患者就诊时已是局部晚期甚至已出现远处转移。

经过筛选早期鼻咽癌患者有或许改善治疗疗效。尽管血清学EBV IgA检查通常用于评估患者,但对于可疑的鼻咽癌因EBV IgA敏感性和特异性较低无法判断。科研证实,血浆中EBV DNA的剖析可以发现早期无症状鼻咽癌。



文献来源:

K.C. Allen Chan, et al. Analysis of Plasma Epstein–Barr Virus DNA toScreen for Nasopharyngeal Cancer. N Engl J Med 2017; 377:513-522.

XML 地图 | Sitemap 地图