在EBV相关的鼻咽癌(NPC)中,循环EBV-DNA(cEBV-DNA)的定量测定可用作疾病标志物。该研究的目的是调查临床实践指南中是否建立了cEBV-DNA的临床效用,以及是否提供了标准化定量cEBV-DNA测定的建议。
对2011年以来发表的NPC指南进行了系统的文献检索。在增加简化的连续步骤中合成了cEBV-DNA检测方法和在临床实践中使用的信息。
从搜索确定的570个标题和摘要中,包括16条准则。选定的文件被进一步归类为基于系统的文献修订以生成建议(4/16)或不(12/16)。cEBV-DNA仅在一个基于系统修订的指南和8个没有系统修订的指南中进行评估。一半的可用指南为其临床使用提供了建议。31%的指南讨论了cEBV-DNA测定的方法学问题,没有提供任何关于方法标准化的建议。
由于其预后价值,cEBV-DNA在治疗前的后处理和随访中被建议。指南生产者需要更多地考虑影响实验室结果的实际可靠性和普遍性的方法方面。
In EBV-related nasopharyngeal carcinoma (NPC), quantitative determination of circulating EBV-DNA (cEBV-DNA) can potentially be applied as disease marker. The aim of the study was to investigate if the clinical utility of cEBV-DNA is established in clinical practice guidelines and if recommendations are provided to standardize the quantitative cEBV-DNA determination.
A systematic literature search for NPC
guidelines published since 2011 was performed. Information for cEBV-DNA detection method and use in clinical practice was synthesized in consecutive steps of increasing simplification.
From 570 titles and abstracts identified by the search, 16 guidelines were included. The selected documents were further clustered as either being based on a systematic literature revision to generate recommendations (4/16) or not (12/16). cEBV-DNA was evaluated in only one
guideline based on a systematic revision and in 8
guidelines without systematic revision. Half of available
guidelines provide recommendation for its clinical use. Methodological issues on cEBV-DNA determination are discussed by 31% of guidelines, without providing any recommendation on method standardization.
Due to its prognostic value, cEBV-DNA is suggested in the pre-treatment work-up and in the follow-up.
Guideline producers need to take into more consideration methodological aspects impacting the actual reliability and generalizability of laboratory results.