Correlation Analysis Between Plasma EBV-DNA Level And Disease Stageing And Tumor Volume In Hunan Xiangxi Area

Objective: To analysis the correlation between plasma EBV-DNA levels and disease stage and tumor volume in patients who suffer nasopharyngeal cancer,then to explore the correlation between the EB virus and nasopharyngeal cancer in Hunan Xiangxi area,and to provide the basis for developing a more effective prognosis prediction system.Methods:(1)A retrospective analysis of Xiangxi Autonomous Prefe cture People's Hospital,113 patients were admitted with pathological d iagnosis and no distant metastasis of nasopharyngeal carcinoma arrang ed from December 2017 and December 2018.Patients were assessed r espectively,using the Chinese 2008 staging system and the eighth edit ion AJCC staging system.The correlation between baseline plasma EB V-DNA level and the Chinese 2008 staging system and the eighth ed ition AJCC staging system was analyzed.(2)Radiotherapy planning s ystem(Eclipse system)was used to calculate tumor volume,the correl ation between baseline plasma EBV-DNA level and tumor volume w as analyzed.Results:(1)Among 113 patients,Kappa values in the T,N and clinicalstage were 0.731,0.825 and 0.818 respectively of the Chinese 2008 staging system and the eighth edition AJCC staging system.The consistency of T staging was general,but that of N staging and clinical staging was good.(2)The positive rate of EBV-DNA was 79.6%,and there was no statistical difference for the positive rate of EBV-DNA in T staging(P > 0.05),but significant difference in N staging and Clinical staging in 2008 Chinese staging or the eighth edition AJCC staging system(P < 0.05).(3)There was no correlation between EBV-DNA level and T staging in 2008 Chinese staging(P=0.082),but EBV-DNA level was correlation with N staging and clinical staging(P=0.000/0.001).The EBV-DNA level was significant correlated with T staging,N and clinical staging in the eighth edition AJCC staging system(P=0.013/0.000/0.000).EBV-DNA level was also associated with invasion of basilar skull,invasion of cavernous sinus,liquefaction and necrosis of lymph nodes,and invasion of extracapsular lymph nodes(P=0.024/0.025/0.000/0.002).(4)There was poor correlation between plasma EBV-DNA level and primary tumor volume(Rank correlation coeffi cient,R=0.176,P=0.026),and there were moderately correlated between plasma EBV-DNA level and the volume of metastatic lymph nodes in the neck and the total volume(R=0.432/0.407,P=0.000).(5)Multivariate analysis showed that the volume of cervical metastatic lymph nodes and cavernous sinus invasion were independent imaging factors of plasma EBV-DNA level before treatment.Conclusion:(1)EB virus is related to nasopharyngeal carcinoma in Hunan Xiangxi area,and EBV-NDA has the potential to be a biomarker in nasopharyngeal carcinoma.(2)Cervical lymph nodes' volume is a main factors affecting plasma EBV-DNA level before treatment.Liquefaction,necrosis and envelope invasion of lymph nodes might be the main route for EB virus entering the blood circulation.(3)Among the primary tumor of nasopharyngeal carcinoma,cavernous sinus invasion is the main factor affecting plasma EBV-DNA level before treatment.(4)The level of plasma EBV-DNA and tumor volume are likely to be considered in establishing staging system.And attention should be paid to avoid overlapping effects among these factors and how to establish,still need more study.