EB病毒DNA与鼻咽癌治疗预后之相关联性课件

EB病毒DNA与鼻咽癌治疗预后之相关联性

TherelationshipbetweenEBVDNAandprognosisinnasopharyngealcarcinoma苏彦烨EB病毒DNA与鼻咽癌治疗预后之相关联性

TherelaOutlineIntroductionofnasopharynxIntroductionofnasopharyngealcarcinoma(NPC)RelatedarticlesofEBVDNAandNPCprognosis-EBVDNAlevelandNPCrecurrence-EBVDNAlevelanddistantmetastasis-EBVDNAlevelandsurvival-EBVDNAlevelandtreatmentresponseOutlineIntroductionofnasophaThenasopharynx(nasalpartofthepharynx)istheuppermostpartofthepharynxItextendsfromthebaseoftheskulltotheuppersurfaceofthesoftpalateNasopharynxThenasopharynx(nasalpartofFossaofRosenmullerNasopharynxFossaofRosenmullerNasopharynExaminationofNasopharynxExaminationofNasopharynxEB病毒DNA与鼻咽癌治疗预后之相关联性课件NasopharyngoscopeNasopharyngoscopeFossaofRosenmullerFossaofRosenmullerNasopharyngealCarcinoma(NPC)Epidemiology---CommoninsouthernregionsofChina,particularlyinGuangdong,Fujian,Hong-kongandTaiwan150casesper100,000peopleinGuangdong,7.7casesper100,000peopleinTaiwan,and0.1~1.7per100,000peopleinUSANPCisseenprimarilyinmiddle-aged(45~55y/o)personsinAsia,ahighproportionofAfricancasesappearinchildrenNasopharyngealCarcinoma(NPC)Etiology---Cause??NotclearEBvirus-relatedtoundifferentiatedtypeGene-(HLA-A2,Aw19,BSin2,B17,BW16)Diet(saltedvegetables,fishandmeat-dimethylnitrosamines)Environmentsmoking,nickelexposure,formaldehyde(甲醛)NasopharyngealCarcinoma(NPC)Etiology---NasopharyngealCaNPCNormalNPCNormalSymptomsandSignsNeckmassEarfullnessandhearingimpairment(middleeareffusion)BloodtingledsputumNasalobstructionHeadacheDiplopiaSymptomsandSignsNeckmassDiagnosisandTreatmentBiopsy!!!TreatmentRadiotherapy+/-chemotherapyOperation(salvage)DiagnosisandTreatmentBiopsyRelatedArticlesof

EBVDNAandNPCprognosisRelatedArticlesof

EBVDNAaEBVDNAlevelandNPCrecurrenceEBVDNAlevelandNPCrecurrenEBVDNAlevelandNPCrecurrencePlasma/serumcell-freeEBVDNAmaybeavaluabletoolforthemonitorofNPCpatientsfortheearlydetectionoftumorrecurrenceLoYM.etal.CancerRes.1999CirculatingEBVDNAhasbeenfoundnotonlytocorrelatewithdiseasestaging,butalsotoprovideusefulinformationforthemonitoringfortumorrecurrenceLoYM.etal.BiomedPharmacother.2001.ReviewThefailureofcompleteandrapideliminationofEBVDNAfromthecirculationpredictsdiseaserecurrenceToEW.etal.ClinCancerRes.2003EBVDNAlevelandNPCrecurrenThisstudyprovideconvincingevidencefortheuseofplasmaEBVDNAmeasurementsfortheearlydiagnosisandstagingofNPCawellasformonitoringrecurrenceandmetastasisofthistumorShaoJY.etal.Cancer.2004TheusefulnessofEBVDNAasausefultoolinmonitoringNPCbyitsabilitytodetectearlyrecurrenceandexcellentcorrelationwithtreatmentresponseChanSLetal.BMCCancer.2006TheplasmaEBVDNAassaycorrectlypredictedallNPCrecurrences,andPEThadhighcapacitytolocalizepotentiallesionsitesWangWYetal.Cancer.2011EBVDNAlevelandNPCrecurrenceThisstudyprovideconvincingTherisksofloco-regionalfailurewerenotsignificantlydifferentbetweenpatientswithhighandthosewithlowEBVDNAlevelsLeungSF.etal.Cancer.2003PlasmaEBVDNAloadmeasurementappearstobeusefulinalowtumorriskarea(westernEurope).However,developmentoflocalrecurrencesmaynotalwayscoincidewithraisedlevelofEBVDNAKalpoeJS.etal.JClinPathol.2006EBVDNAlevelandNPCrecurrenceTherisksofloco-regionalfaiConclusion---NPCrecurrencewashighlyrelatedtoEBVDNAlevel,butnotalwayscoincidedWithanasymptomaticriseintheplasmaEBVDNAlevel,tumorrecurrenceshouldbeconsideredEBVDNAlevelandNPCrecurrenceConclusion---EBVDNAlevelanEBVDNAlevelanddistantmetastasisEBVDNAlevelanddistantmetaEBVDNAlevelanddistantmetastasisPatientswithdistantfailurehadsignificantlyhigherpre-therapyEBVDNAlevelsthanthosewithoutfailureLeungSF.etal.Cancer2003KaplanMeierplotoffreedomfromdistantfailureforpatientsubgroupswithhighversuslowpretherapyEpsteinBarrvirus(EBV)DNAlevelsEBVDNAlevelanddistantmetaThetimetothefirstdetectionofcirculatingEBVDNAwassignificantlyshorteramongpatientswithdistantmetastasis.MonitoringplasmaEBVDNAlevelsurpassedtraditionalmethodsfortheearlydetectionofdistantfailureinpatientswithNPCHongRL.etal.Cancer.2004TheuseofplasmaEBVDNAmeasurementsfortheearlydiagnosisandstagingofNPCawellasformonitoringrecurrenceandmetastasisofthistumorShaoJY.etal.Cancer2004EBVDNAlevelanddistantmetastasisThetimetothefirstdetectioConclusion---EBVDNAlevelwashighlyrelatedtodistantmetastasisClosemonitoringEBVDNAlevelcouldearlydetectdistantfailureinNPCpatientsEBVDNAlevelanddistantmetastasisConclusion---EBVDNAlevelanEBVDNAlevelandsurvivalEBVDNAlevelandsurvivalLevelsofpost-treatmentplasmaEBVDNAinpatientswithNPCappeartostronglypredictprogression-freeandoverallsurvivalandtoaccuratelyreflectthepost-treatmentresidualtumorloadChanAT.etal.JNatlCancerinst.2002Pre-therapycirculatingEBVDNAloadisanindependentprognosticfactorforoverallsurvivalinNPCLeungSF.etal.JClinOncol.2006EBVDNAlevelandsurvivalLevelsofpost-treatmentplasmSurvivalprobabilitiesofpatientgroupsaccordingtoEpstein-Barrvirus(EBV)DNAlevels.LowDNAdenoteslowEBVDNAlevelsoflessthan4000copies/ml,andhighDNAdenoteshighEBVDNAlevelsof4000copies/mlLeungSF.etal.JClinOncol.2006SurvivalprobabilitiesofpatiEBVDNAstatusremainsastrongpredictorforoverallsurvivalinNPCKennethWY.etal.ClinCancerRes.2006Metastatic/recurrentNPCpatientswithlowpre-treatmentplasmaEBVDNAlevelandundetectablepost-treatmentplasmaEBVDNAshowedafavorableprognosisandsurvivalAnX.etal.Cancer.2011EBVDNAlevelandsurvivalEBVDNAstatusremainsastronThe5-yearoverallsurvivalrateinlowpre-treatmentplasmaEBVDNAlevelandundetectablepost-treatmentplasmaEBVDNAsubgroupwas50.6%.However,nopatientsintheother3subgroupssurvived5yearsAnX.etal.Cancer.2011The5-yearoverallsurvivalraConclusion---EBVDNAlevelwashighlyrelatedtosurvivalrateLowerpre-treatmentplasmaEBVDNAlevelandundetectablepost-treatmentplasmaEBVDNAshowedthebestprognosisEBVDNAlevelandsurvivalConclusion---EBVDNAlevelanEBVDNAlevelandtreatmentresponseEBVDNAlevelandtreatmentreEBVDNAlevelandtreatmentresponseRapidclearanceofplasmaEpstein-BarrvirusDNAaftersurgicaltreatmentofnasopharyngealcarcinomaToEW.etal.ClinCanerRes.2003TheinvivoeliminationofEBVDNAisveryrapidaftersurgicalresectionofNPCThefailureofcompleteandrapideliminationofEBVDNAfromthecirculationpredictsdiseaserecurrenceEBVDNAlevelandtreatmentrePlasmaEBVDNAclearancerateasanovelprognosticmarkerformetastatic/recurrentnasopharyngealcarcinomaWangWY.etal.ClinCancerRes.2010Patientswithashortt1/2ofplasmaEBVDNAclearancehavesignificantlyhighercompleteresponserateandoverallsurvivalthanthosewithlongt1/2TheplasmaEBVDNAconcentrationshavenosignificanteffectsonoutcomepredictionEBVDNAlevelandtreatmentresponsePlasmaEBVDNAclearancerateEB病毒DNA与鼻咽癌治疗预后之相关联性课件EB病毒DNA与鼻咽癌治疗预后之相关联性课件TheplasmaEBVDNAconcentrationshavenosignificanteffectsonoutcomepredictionThet1/2ofplasmaEBVDNAclearanceshowssignificanteffectsontumorresponseTheplasmaEBVDNAconcentratiTheclearanceratesofplasmaEBVDNAduringthefirstmonthofchemotherapycanpredicttumorresponseandpatientsurvivalEarlychangeofchemotherapyregimenmaybeconsideredforpatientswithslowplasmaEBVDNAclearancerateWangWY.etal.ClinCancerRes.2010EBVDNAlevelandtreatmentresponseTheclearanceratesofplasmaConclusion---EBVDNAlevelwasausefultooltomonitortumorresponseaftertherapyTheclearanceratesofplasmaEBVDNAseemedbetterthantheconcentrationofplasmaEBVDNAinpredictingtumorresponseEBVDNAlevelandtreatmentresponseConclusion---EBVDNAlevelanConclusionEBVDNAlevelwasausefultoolinmonitoringtumorrecurrence,distantmetastasis,survivalandtreatmentresponseinnasopharyngealcarcinomaConclusionEBVDNAlevelwasaThanksforYourAttention!!!ThanksforYourAttention!!EB病毒DNA与鼻咽癌治疗预后之相关联性

TherelationshipbetweenEBVDNAandprognosisinnasopharyngealcarcinoma苏彦烨EB病毒DNA与鼻咽癌治疗预后之相关联性

TherelaOutlineIntroductionofnasopharynxIntroductionofnasopharyngealcarcinoma(NPC)RelatedarticlesofEBVDNAandNPCprognosis-EBVDNAlevelandNPCrecurrence-EBVDNAlevelanddistantmetastasis-EBVDNAlevelandsurvival-EBVDNAlevelandtreatmentresponseOutlineIntroductionofnasophaThenasopharynx(nasalpartofthepharynx)istheuppermostpartofthepharynxItextendsfromthebaseoftheskulltotheuppersurfaceofthesoftpalateNasopharynxThenasopharynx(nasalpartofFossaofRosenmullerNasopharynxFossaofRosenmullerNasopharynExaminationofNasopharynxExaminationofNasopharynxEB病毒DNA与鼻咽癌治疗预后之相关联性课件NasopharyngoscopeNasopharyngoscopeFossaofRosenmullerFossaofRosenmullerNasopharyngealCarcinoma(NPC)Epidemiology---CommoninsouthernregionsofChina,particularlyinGuangdong,Fujian,Hong-kongandTaiwan150casesper100,000peopleinGuangdong,7.7casesper100,000peopleinTaiwan,and0.1~1.7per100,000peopleinUSANPCisseenprimarilyinmiddle-aged(45~55y/o)personsinAsia,ahighproportionofAfricancasesappearinchildrenNasopharyngealCarcinoma(NPC)Etiology---Cause??NotclearEBvirus-relatedtoundifferentiatedtypeGene-(HLA-A2,Aw19,BSin2,B17,BW16)Diet(saltedvegetables,fishandmeat-dimethylnitrosamines)Environmentsmoking,nickelexposure,formaldehyde(甲醛)NasopharyngealCarcinoma(NPC)Etiology---NasopharyngealCaNPCNormalNPCNormalSymptomsandSignsNeckmassEarfullnessandhearingimpairment(middleeareffusion)BloodtingledsputumNasalobstructionHeadacheDiplopiaSymptomsandSignsNeckmassDiagnosisandTreatmentBiopsy!!!TreatmentRadiotherapy+/-chemotherapyOperation(salvage)DiagnosisandTreatmentBiopsyRelatedArticlesof

EBVDNAandNPCprognosisRelatedArticlesof

EBVDNAaEBVDNAlevelandNPCrecurrenceEBVDNAlevelandNPCrecurrenEBVDNAlevelandNPCrecurrencePlasma/serumcell-freeEBVDNAmaybeavaluabletoolforthemonitorofNPCpatientsfortheearlydetectionoftumorrecurrenceLoYM.etal.CancerRes.1999CirculatingEBVDNAhasbeenfoundnotonlytocorrelatewithdiseasestaging,butalsotoprovideusefulinformationforthemonitoringfortumorrecurrenceLoYM.etal.BiomedPharmacother.2001.ReviewThefailureofcompleteandrapideliminationofEBVDNAfromthecirculationpredictsdiseaserecurrenceToEW.etal.ClinCancerRes.2003EBVDNAlevelandNPCrecurrenThisstudyprovideconvincingevidencefortheuseofplasmaEBVDNAmeasurementsfortheearlydiagnosisandstagingofNPCawellasformonitoringrecurrenceandmetastasisofthistumorShaoJY.etal.Cancer.2004TheusefulnessofEBVDNAasausefultoolinmonitoringNPCbyitsabilitytodetectearlyrecurrenceandexcellentcorrelationwithtreatmentresponseChanSLetal.BMCCancer.2006TheplasmaEBVDNAassaycorrectlypredictedallNPCrecurrences,andPEThadhighcapacitytolocalizepotentiallesionsitesWangWYetal.Cancer.2011EBVDNAlevelandNPCrecurrenceThisstudyprovideconvincingTherisksofloco-regionalfailurewerenotsignificantlydifferentbetweenpatientswithhighandthosewithlowEBVDNAlevelsLeungSF.etal.Cancer.2003PlasmaEBVDNAloadmeasurementappearstobeusefulinalowtumorriskarea(westernEurope).However,developmentoflocalrecurrencesmaynotalwayscoincidewithraisedlevelofEBVDNAKalpoeJS.etal.JClinPathol.2006EBVDNAlevelandNPCrecurrenceTherisksofloco-regionalfaiConclusion---NPCrecurrencewashighlyrelatedtoEBVDNAlevel,butnotalwayscoincidedWithanasymptomaticriseintheplasmaEBVDNAlevel,tumorrecurrenceshouldbeconsideredEBVDNAlevelandNPCrecurrenceConclusion---EBVDNAlevelanEBVDNAlevelanddistantmetastasisEBVDNAlevelanddistantmetaEBVDNAlevelanddistantmetastasisPatientswithdistantfailurehadsignificantlyhigherpre-therapyEBVDNAlevelsthanthosewithoutfailureLeungSF.etal.Cancer2003KaplanMeierplotoffreedomfromdistantfailureforpatientsubgroupswithhighversuslowpretherapyEpsteinBarrvirus(EBV)DNAlevelsEBVDNAlevelanddistantmetaThetimetothefirstdetectionofcirculatingEBVDNAwassignificantlyshorteramongpatientswithdistantmetastasis.MonitoringplasmaEBVDNAlevelsurpassedtraditionalmethodsfortheearlydetectionofdistantfailureinpatientswithNPCHongRL.etal.Cancer.2004TheuseofplasmaEBVDNAmeasurementsfortheearlydiagnosisandstagingofNPCawellasformonitoringrecurrenceandmetastasisofthistumorShaoJY.etal.Cancer2004EBVDNAlevelanddistantmetastasisThetimetothefirstdetectioConclusion---EBVDNAlevelwashighlyrelatedtodistantmetastasisClosemonitoringEBVDNAlevelcouldearlydetectdistantfailureinNPCpatientsEBVDNAlevelanddistantmetastasisConclusion---EBVDNAlevelanEBVDNAlevelandsurvivalEBVDNAlevelandsurvivalLevelsofpost-treatmentplasmaEBVDNAinpatientswithNPCappeartostronglypredictprogression-freeandoverallsurvivalandtoaccuratelyreflectthepost-treatmentresidualtumorloadChanAT.etal.JNatlCancerinst.2002Pre-therapycirculatingEBVDNAloadisanindependentprognosticfactorforoverallsurvivalinNPCLeungSF.etal.JClinOncol.2006EBVDNAlevelandsurvivalLevelsofpost-treatmentplasmSurvivalprobabilitiesofpatientgroupsaccordingtoEpstein-Barrvirus(EBV)DNAlevels.LowDNAdenoteslowEBVDNAlevelsoflessthan4000copies/ml,andhighDNAdenoteshighEBVDNAlevelsof4000copies/mlLeungSF.etal.JClinOncol.2006SurvivalprobabilitiesofpatiEBVDNAstatusremainsastrongpredictorforoverallsurvivalinNPCKennethWY.etal.ClinCancerRes.2006Metastatic/recurrentNPCpatientswithlowpre-treatmentplasmaEBVDNAlevelandundetectablepost-treatmentplasmaEBVDNAshowedafavorableprognosisandsurvivalAnX.etal.Cancer.2011EBVDNAlevelandsurvivalEBVDNAstatusremainsastronThe5-yearoverallsurvivalrateinlowpre-treatmentplasmaEBVDNAlevelandundetectablepost-treatmentplasmaEBVDNAsubgroupwas50.6%.However,nopatientsintheother3subgroupssurvived5yearsAnX.etal.Cancer.2011The5-yearoverallsurvivalraConclusion---EBVDNAlevelwashighlyrelatedtosurvivalrateLowerpre-treatmentplasmaEBVDNAlevelandundetectablepost-treatmentplasmaEBVDNAshowedthebestprognosisEBVDNAlevelandsurvivalConclusion---EBVDNAlevelanEBVDNAlevelandtreatmentresponseEBVDNAlevelandtreatmentreEBVDNAlevelandtreatmentresponseRapidclearanceofplasmaEpstein-BarrvirusDNAaftersurgicaltreatmentofnasopharyngealcarcinomaToEW.etal.ClinCanerRes.2003