EB病毒DNA和鼻咽癌治疗预后之相关联性培训ppt课件

EB病毒病毒DNA和鼻咽癌和鼻咽癌治治疗预疗预后之相关后之相关联联性性EB病毒DNA和鼻咽癌治疗预后之相关联性1OutlineIntroduction of nasopharynxIntroduction of nasopharyngeal carcinoma(NPC)Related articles of EBV DNA and NPC prognosis -EBV DNA level and NPC recurrence -EBV DNA level and distant metastasis -EBV DNA level and survival -EBV DNA level and treatment response 2EB病毒DNA和鼻咽癌治疗预后之相关联性OutlineIntroduction of nasopha2The nasopharynx(nasal part of the pharynx)is the uppermost part of the pharynx It extends from the base of the skull to the upper surface of the soft palate Nasopharynx3EB病毒DNA和鼻咽癌治疗预后之相关联性The nasopharynx(nasal part of3Fossa of RosenmullerFossa of RosenmullerFossa of RosenmullerFossa of RosenmullerNasopharynx4EB病毒DNA和鼻咽癌治疗预后之相关联性Fossa of RosenmullerNasopharyn4Examination of Nasopharynx5EB病毒DNA和鼻咽癌治疗预后之相关联性Examination of Nasopharynx5EB病56EB病毒DNA和鼻咽癌治疗预后之相关联性6EB病毒DNA和鼻咽癌治疗预后之相关联性6Nasopharyngoscope7EB病毒DNA和鼻咽癌治疗预后之相关联性Nasopharyngoscope7EB病毒DNA和鼻咽癌治7Fossa of Rosenmuller8EB病毒DNA和鼻咽癌治疗预后之相关联性Fossa of Rosenmuller8EB病毒DNA和鼻8Nasopharyngeal Carcinoma(NPC)Epidemiology-Epidemiology-Common in southern regions of Common in southern regions of China,particularly in Guangdong,China,particularly in Guangdong,Fujian,Hong-kong and Taiwan Fujian,Hong-kong and Taiwan 150 cases per 100,000 people in 150 cases per 100,000 people in Guangdong,7.7 cases per 100,000 Guangdong,7.7 cases per 100,000 people in Taiwan,and 0.11.7 per people in Taiwan,and 0.11.7 per 100,000 people in USA100,000 people in USANPC is seen primarily in middle-NPC is seen primarily in middle-aged(4555 y/o)persons in Asia,a aged(4555 y/o)persons in Asia,a high proportion of African cases high proportion of African cases appear in childrenappear in children9EB病毒DNA和鼻咽癌治疗预后之相关联性Nasopharyngeal Carcinoma(NPC)9Etiology-Etiology-Cause?Not clearCause?Not clearEB virus-related to EB virus-related to undifferentiated typeundifferentiated typeGene-(HLA-A2,Aw19,BSin 2,Gene-(HLA-A2,Aw19,BSin 2,B17,BW16)B17,BW16)Diet (salted vegetables,fish and Diet (salted vegetables,fish and meat-dimethylnitrosamines)meat-dimethylnitrosamines)Environment smoking,nickel Environment smoking,nickel exposure,formaldehyde(exposure,formaldehyde(甲醛甲醛)Nasopharyngeal Carcinoma(NPC)10EB病毒DNA和鼻咽癌治疗预后之相关联性Etiology-Nasopharyngeal Ca10NPCNormal11EB病毒DNA和鼻咽癌治疗预后之相关联性NPCNormal11EB病毒DNA和鼻咽癌治疗预后之相关联11Symptoms and SignsNeck massEar fullness and hearing impairment (middle ear effusion)Blood tingled sputumNasal obstruction Headache Diplopia12EB病毒DNA和鼻咽癌治疗预后之相关联性Symptoms and SignsNeck mass12E12Diagnosis and Treatment Biopsy!Treatment Radiotherapy+/-chemotherapy Operation(salvage)13EB病毒DNA和鼻咽癌治疗预后之相关联性Diagnosis and Treatment Biopsy13Related Articles of Related Articles of EBV DNA and NPC prognosis EBV DNA and NPC prognosis 14EB病毒DNA和鼻咽癌治疗预后之相关联性Related Articles of EBV DNA a14EBV DNA level and NPC recurrence15EB病毒DNA和鼻咽癌治疗预后之相关联性EBV DNA level and NPC recurren15EBV DNA level and NPC recurrencePlasma/serum cell-free EBV DNA may be a valuable tool for the monitor of NPC patients for the early detection of tumor recurrence Lo YM.et al.Cancer Res.1999 Circulating EBV DNA has been found not only to correlate with disease staging,but also to provide useful information for the monitoring for tumor recurrence Lo YM.et al.Biomed Pharmacother.2001.ReviewThe failure of complete and rapid elimination of EBV DNA from the circulation predicts disease recurrence To EW.et al.Clin Cancer Res.200316EB病毒DNA和鼻咽癌治疗预后之相关联性EBV DNA level and NPC recurren16This study provide convincing evidence for the use of plasma EBV DNA measurements for the early diagnosis and staging of NPC a well as for monitoring recurrence and metastasis of this tumor Shao JY.et al.Cancer.2004The usefulness of EBV DNA as a useful tool in monitoring NPC by its ability to detect early recurrence and excellent correlation with treatment response Chan SL et al.BMC Cancer.2006The plasma EBV DNA assay correctly predicted all NPC recurrences,and PET had high capacity to localize potential lesion sites Wang WY et al.Cancer.2011EBV DNA level and NPC recurrence17EB病毒DNA和鼻咽癌治疗预后之相关联性This study provide convincing 17The risks of loco-regional failure were not significantly different between patients with high and those with low EBV DNA levels Leung SF.et al.Cancer.2003Plasma EBV DNA load measurement appears to be useful in a low tumor risk area(western Europe).However,development of local recurrences may not always coincide with raised level of EBV DNA Kalpoe JS.et al.J Clin Pathol.2006 EBV DNA level and NPC recurrence18EB病毒DNA和鼻咽癌治疗预后之相关联性The risks of loco-regional fai18Conclusion-NPC recurrence was highly related to EBV DNA level,but not always coincidedWith an asymptomatic rise in the plasma EBV DNA level,tumor recurrence should be consideredEBV DNA level and NPC recurrence19EB病毒DNA和鼻咽癌治疗预后之相关联性Conclusion-EBV DNA level an19EBV DNA level and distant metastasis 20EB病毒DNA和鼻咽癌治疗预后之相关联性EBV DNA level and distant meta20EBV DNA level and distant metastasis Patients with distant failure had significantly higher pre-therapy EBV DNA levels than those without failure Leung SF.et al.Cancer 2003Kaplan Meier plot of freedom from distant failure for patient subgroups with high versus low pretherapy Epstein Barr virus(EBV)DNA levels21EB病毒DNA和鼻咽癌治疗预后之相关联性EBV DNA level and distant meta21EB病毒DNA和鼻咽癌治疗预后之相关联性培训ppt课件22Conclusion-EBV DNA level was highly related to distant metastasisClose monitoring EBV DNA level could early detect distant failure in NPC patientsEBV DNA level and distant metastasis 23EB病毒DNA和鼻咽癌治疗预后之相关联性Conclusion-EBV DNA level an23EBV DNA level and survival24EB病毒DNA和鼻咽癌治疗预后之相关联性EBV DNA level and survival24EB24Levels of post-treatment plasma EBV DNA in patients with NPC appear to strongly predict progression-free and overall survival and to accurately reflect the post-treatment residual tumor load Chan AT.et al.J Natl Cancer inst.2002Pre-therapy circulating EBV DNA load is an independent prognostic factor for overall survival in NPC Leung SF.et al.J Clin Oncol.2006EBV DNA level and survival25EB病毒DNA和鼻咽癌治疗预后之相关联性Levels of post-treatment plasm25Survival probabilities of patient groups according to Epstein-Barr virus(EBV)DNA levels.Low DNA denotes low EBV DNA levels of less than 4000 copies/ml,and high DNA denotes high EBV DNA levels of 4000 copies/ml Leung SF.et al.J Clin Oncol.200626EB病毒DNA和鼻咽癌治疗预后之相关联性Survival probabilities of pati26EBV DNA status remains a strong predictor for overall survival in NPC Kenneth WY.et al.Clin Cancer Res.2006Metastatic/recurrent NPC patients with low pre-treatment plasma EBV DNA level and undetectable post-treatment plasma EBV DNA showed a favorable prognosis and survival An X.et al.Cancer.2011EBV DNA level and survival27EB病毒DNA和鼻咽癌治疗预后之相关联性EBV DNA status remains a stron27The 5-year overall survival rate in low pre-treatment plasma EBV DNA level and undetectable post-treatment plasma EBV DNA subgroup was 50.6%.However,no patients in the other 3 subgroups survived 5 years An X.et al.Cancer.201128EB病毒DNA和鼻咽癌治疗预后之相关联性The 5-year overall survival ra28Conclusion-EBV DNA level was highly related to survival rateLower pre-treatment plasma EBV DNA level and undetectable post-treatment plasma EBV DNA showed the best prognosisEBV DNA level and survival29EB病毒DNA和鼻咽癌治疗预后之相关联性Conclusion-EBV DNA level an29EBV DNA level and treatment response30EB病毒DNA和鼻咽癌治疗预后之相关联性EBV DNA level and treatment re30EBV DNA level and treatment responseRapid clearance of plasma Epstein-Barr virus DNA after surgical treatment of nasopharyngeal carcinoma To EW.et al.Clin Caner Res.2003The in vivo elimination of EBV DNA is very rapid after surgical resection of NPCThe failure of complete and rapid elimination of EBV DNA from the circulation predicts disease recurrence 31EB病毒DNA和鼻咽癌治疗预后之相关联性EBV DNA level and treatment re31Plasma EBV DNA clearance rate as a novel prognostic marker for metastatic/recurrent nasopharyngeal carcinoma Wang WY.et al.Clin Cancer Res.2010Patients with a short t1/2 of plasma EBV DNA clearance have significantly higher complete response rate and overall survival than those with long t1/2 The plasma EBV DNA concentrations have no significant effects on outcome predictionEBV DNA level and treatment response32EB病毒DNA和鼻咽癌治疗预后之相关联性Plasma EBV DNA clearance rate 3233EB病毒DNA和鼻咽癌治疗预后之相关联性33EB病毒DNA和鼻咽癌治疗预后之相关联性3334EB病毒DNA和鼻咽癌治疗预后之相关联性34EB病毒DNA和鼻咽癌治疗预后之相关联性34The plasma EBV DNA concentrations have no significant effects on outcome predictionThe t1/2 of plasma EBV DNA clearance shows significant effects on tumor response 35EB病毒DNA和鼻咽癌治疗预后之相关联性The plasma EBV DNA concentrati35The clearance rates of plasma EBV DNA during the first month of chemotherapy can predict tumor response and patient survivalEarly change of chemotherapy regimen may be considered for patients with slow plasma EBV DNA clearance rate Wang WY.et al.Clin Cancer Res.2010EBV DNA level and treatment response36EB病毒DNA和鼻咽癌治疗预后之相关联性The clearance rates of plasma 36Conclusion-EBV DNA level was a useful tool to monitor tumor response after therapyThe clearance rates of plasma EBV DNA seemed better than the concentration of plasma EBV DNA in predicting tumor responseEBV DNA level and treatment response37EB病毒DNA和鼻咽癌治疗预后之相关联性Conclusion-EBV DNA level an37Conclusion EBV DNA level was a useful tool in monitoring tumor recurrence,distant metastasis,survival and treatment response in nasopharyngeal carcinoma38EB病毒DNA和鼻咽癌治疗预后之相关联性Conclusion EBV DNA level was a38 Thanks for Your Thanks for Your Attention!Attention!39EB病毒DNA和鼻咽癌治疗预后之相关联性 Thanks for Your Attention!39