摘要目的 检测鼻型结外NK/T细胞淋巴瘤(ENKL)患者血清EB病毒核抗原1(EBNA1)、潜伏膜蛋白1(LMP1),探讨其与ENKL的关系.方法 选取首都医科大学北京同仁医院2010年8月到2013年8月新诊断ENKL患者36例、健康对照者20例,以EBNA1、LMP1为目的基因,采用实时定量PCR方法分别检测ENKL患者治疗前后和健康对照者外周血EBNA1、LMP1.结果 治疗前,ENKL患者血清EBNA1中位数为1.9×104(0 ～ 11.0×104)拷贝/μl,健康对照组为8.0(0 ～43.8)拷贝/μl;ENKL患者LMP1中位数为3.9 ×103(118.3 ～24.0×103)拷贝/μl,健康对照组为3.3(0～33.3)拷贝/μl.治疗前ENKL患者EBNA1、LMP1均显著高于健康对照组(P均＜0.01).治疗后,ENKL患者血清EBNA1中位数为1.0×103(0 ～2.0×103)拷贝/μl,LMP1为300.8(0 ～825.7)拷贝/μl,两者较治疗前均显著降低(P＜0.05).治疗有效患者的治疗后EBNA1、LMP1中位数均低于治疗无效的患者(P＜0.05).治疗前ENKL患者EBNA1、LMP1与血清乳酸脱氢酶水平呈正相关(r=0.364、0.546,P=0.040、0.012).EBNA1、LMP1低于临界值(EBNA1:1.3×104拷贝/μl; LMP1:3.0×103拷贝/μl)患者的2年总生存率和无进展生存率优于EBNA1、LMP1高于临界值者,但差异无统计学意义(P均＞0.05).结论 (1)检测ENKL患者血清EBNA1和LMP1对评判治疗效果具有一定价值;(2)ENKL患者血清EBNA1、LMP1可反映肿瘤负荷.

abstractsObjective To explore the clinical significance of the serum Epstein-Barr virus determined nuclear antigen 1 (EBNA1)/latent membrane protein 1 (LMP1) in patients with extranodal NK/T-cell lymphoma,nasal type (ENKL).Methods The serum EBNA1 and LMP1 were detected by realtime PCR in 36 ENKL patients hospitalized in Beijing Tongren Hospital from August 2010 to August 2013.Twenty healthy volunteers were recruited as controls.Results The median serum EBNA1 was 1.9 × 104 (ranged from 0 to 11.0 × 104) copies/μl in ENKL patients and 8.0 (ranged from 0 to 43.8) copies/μl in healthy volunteers.The median serum LMP1 was 3.9 × 103 (ranged from 118.3 to 24.0 × 103) copies/μl in ENKL patients and 3.3 (ranged from 0 to 33.3) copies/μl in healthy volunteers.Both EBNA1 and LMP1 were higher in ENKL patients than healthy volunteers (all P ＜ 0.01).The median EBNA1 and LMP1 in ENKL patients posttreatment were 1.0 × 103 (ranged from 0 to 2.0 × 103) copies/μl and 300.8(ranged from 0 to 825.7) copies/μl respectively,which were both significantly decreased than pretreatment (all P ＜ 0.05).The EBNA1 and LMP1 were decreased in effective treatment group versus ineffective treatment group (P ＜0.05).The serum EBNA1 and LMP1 were positively correlated with lactic dehydrogenase (LDH) level (r =0.364,0.546 ; P =0.040,0.012).Conclusions (1) The measurement of EBNA1/LMP1 may be useful in evaluating the therapeutic effect.(2)The serum EBNA1/LMP1 may reflect the tumor load in ENKL patients.