【摘要】 目的 探讨血浆EB病毒DNA(EBV-DNA)联合窄带成像技术(NBI)在鼻咽癌(NPC)复发监测中的应用价值。方法 选取NPC复发患者86例和未复发患者142例为研究对象，观察EBV-DNA、NBI、EBV-DNA联合NBI方法在NPC复发诊断中的灵敏度、特异度、阳性预测值、阴性预测值、一致性检验(Kappa值);采用受试者工作特征曲线(ROC)分析EBV-DNA、NBI、EBV-DNA联合NBI诊断NPC复发的曲线下面积(AUC)。结果 ROC分析结果显示，EBV-DNA、NBI、EBV-DNA联合NBI诊断NPC复发的AUC分别为0.826、0.845、0.893,EBV-DNA联合NBI预测复发的AUC比单一方法检测大，差异具有统计学意义(P<0.05)。分层分析结果显示，预测早期患者NPC复发和晚期NPC复发的AUC为0.924和0.865,Kappa值为0.827和0.696。结论 在监测NPC复发诊断中，EBV-DNA联合NBI方法比单一方法效能高，在临床分期为早期的NPC患者中效果更佳，值得临床上应用推广。更多还原

【Abstract】 Objective To explore the application value of plasma epstein barr-virus DNA(EBV-DNA) combined with narrow-band imaging(NBI) in monitoring the recurrence of nasopharyngeal carcinoma(NPC). Methods 86 patients with recurrent NPC and 142 patients without recurrence were enrolled. The sensitivity, specificity, positive predictive value, negative predictive value, and consistency test(Kappa value) of EBV-DNA, NBI, and EBV-DNA combined with NBI method in the diagnosis of NPC recurrence were observed. Receiver operating characteristic curve(ROC) was used to analyze the area under the curve(AUC) of EBV-DNA, NBI, and EBV-DNA combined with NBI for diagnosing NPC recurrence. Results ROC curve analysis results showed that the AUC of plasma EBV-DNA, NBI and combined diagnosis of NPC recurrence were 0.826, 0.845 and 0.893, respectively, and the AUC of plasma EBV-DNA combined with NBI was greater in predicting recurrence, with a statistically significance difference(P<0.05). The stratified analysis showed that the AUC for predicting the recurrence of NPC in early and late patients was 0.924 and 0.865, and the Kappa value was 0.827 and 0.696. Conclusion In monitoring the diagnosis of NPC recurrence, the EBV-DNA combined with NBI method is more effective than a single method and is more effective in early-stage NPC patients. It is worthy of clinical application and promotion.更多还原