BARF1蛋白特异性CTL免疫应答水平与鼻咽癌Ⅲ、Ⅳa期患者的临床特征和预后关联性分析

发布时间：2018-02-03 03:27

本文关键词： 鼻咽癌 BARF1 CTL 酶联免疫斑点法预后因素　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:使用酶联免疫斑点法(ELISpot)检测鼻咽癌患者EB病毒BARF1蛋白的特异性细胞毒性淋巴细胞(CTL)水平,探讨BARF1抗原蛋白诱导的特异性CTL免疫强度、频率与中晚期鼻咽癌患者临床特征及预后因素的关联性。方法:选择2013年3月~2016年3月新疆肿瘤医院收治的鼻咽癌初治患者92例,用ELISpot检测BARF1蛋白特异性CTL免疫频率与强度,与鼻咽癌的临床特征和预后的因素结合分析。结果:(1)BARF1蛋白特异性CTL免疫频率与强度在一般临床特征比较中,差异均无统计学意义(P0.05)(2)单因素分析结果显示,BARF1特异性CTL免疫阳性反应率对PFS、DMFS有影响,差异有统计学意义(x~2=4.718,P=0.030;x~2=5.499,P=0.019)。(3)多因素结果显示,BARF1阳性反应频率和近期疗效是影响鼻咽癌患者PFS(Exp(β)=0.224,P=0.048,95.0%CI=0.051~0.987;Exp(β)=23.615,P=0.000,95.0%CI=0.040~0.797)和DMFS(Exp(β)=0.179,P=0.024,95.0%CI=0.040~0.797;Exp(β)=29.004,P=0.000,95.0%CI=8.174~102.909)的独立预后因素。结论:(1)BARF 1的特异性CTL免疫阳性反应率、近期疗效可能是鼻咽癌患者的PFS、DMFS的独立预后因素。(2)BARF 1的特异性CTL免疫应答水平可能为中晚期鼻咽癌患者免疫治疗、预测疾病进展及NPC患者预后情况提供实验室依据。
[Abstract]:Objective: to detect the specific cytotoxic lymphocyte count (CTL) of Epstein-Barr virus (EBV) BARF1 protein in patients with nasopharyngeal carcinoma (NPC) by enzyme linked immunoblot assay (Elisa). Objective: to investigate the specific CTL immune intensity induced by BARF1 antigen protein. Methods: 92 patients with nasopharyngeal carcinoma treated in Xinjiang tumor Hospital from March 2013 to March 2016 were selected. The immunological frequency and intensity of BARF1 protein specific CTL were detected by ELISpot. Results the frequency and intensity of specific CTL immunoreactivity of BARF1 protein were compared in general clinical features. The results of univariate analysis showed that BARF1 specific CTL immunoreactive rate had an effect on CTL. The difference was statistically significant (P < 0.05). The results of multivariate analysis showed that xan2 (5.499) (PX) was 0.019 ~ (3) (P < 0.05). The frequency of positive reaction of BARF1 and the short-term curative effect were related to the incidence of BARF1 exp in nasopharyngeal carcinoma patients (尾 -P0. 224P0. 048 + 95. 0CII 0.051 + 0. 987). Exp (尾 ~ (23. 615) ~ (0.000)) and DMFS ~ (0. 179) ~ 0 ~ (0) 0 ~ 0 ~ 0 ~ 0 ~ 0 ~ 0 ~ 0 ~ 0.79 ~ 0 ~ 0 ~ 0 ~ 0 ~ 0 ~ 0. 024. 95.0CIN 0.040 and 0.797; Exp (尾 ~ (29. 004) P = 0. 000). Conclusion the specific CTL immunoreactivity rate of BARF1 is higher than that of BARF1, and the independent prognostic factor is 8.174 / 102.909. Conclusion the specific CTL immunoreactive rate of BARF1 is higher than that of BARF1. The short-term curative effect may be the independent prognostic factor of PFS-1 DMFs.The specific CTL immune response level of BARF1 may be the immunotherapy of advanced nasopharyngeal carcinoma. Prediction of disease progression and prognosis of patients with NPC provides laboratory evidence.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.63

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