Plasma Epstein-Barr virus DNA and risk of nasopharyngeal carcinoma in a prospective seropositive population

Abstract

Objective Plasma Epstein-Barr virus (EBV) DNA is considered a biomarker for nasopharyngeal carcinoma (NPC). However, its long-term role in NPC development is unclear. Materials and methods A total of 1363 participants seropositive for EBV VCA-IgA and EBNA1-IgA in a community-based NPC screening program in southern China were tested for plasma EBV DNA levels by real-time qPCR between 2008 and 2015. New NPC cases were confirmed by active follow-up approach and linkage to local cancer registry through the end of 2016. Cox proportional hazards regression analysis was performed to calculate the hazard ratios (HRs) for NPC risk with plasma EBV DNA. Results Thirty patients were newly diagnosed during a median 7.5 years follow-up. NPC incidence increased with the plasma EBV DNA load ranging from 281.46 to 10,074.47 per 100,000 person-years in participants with undetectable and ≥ 1000 copies/ml levels; the corresponding cumulative incidence rates were 1.73 and 50%. Furthermore, plasma EBV DNA loads conferred an independent risk for NPC development after adjustment for other risk factors, with HRs of 7.63 for > 3–999 copies/ml and 39.79 for ≥1000 copies/ml. However, the HRs decreased gradually after excluding NPC cases detected in the first 2 to 3 years and became statistically nonsignificant by excluding cases detected during the first 4 years. Conclusion Elevated plasma EBV DNA can predict NPC risk over 3 years. Monitoring plasma EBV DNA can be used as a complementary approach to EBV serological antibody-based screening for NPC.

Alpha-fetoprotein–producing recurrent nasopharyngeal carcinoma: A case report

“…A multicenter, phase III, randomized clinical trial provided evidence that gemcitabine plus cisplatin is superior to 5-fluorouracil plus cisplatin in metastatic NPC treatment. 26 Because the patient’s plasma creatinine level was less than 60 mL/(min×1.73 m 2 ), we replaced cisplatin for capecitabine in his treatment regimen. He received two cycles of chemotherapy with gemcitabine 1000 mg/m 2 on days 1 and 8 every 3 weeks, and capecitabine 1500 mg/m 2 on days 1–14 every 3 weeks.…”

“… 1 Plasma Epstein–Barr virus (EBV) DNA is widely used as a biomarker for NPC. 2 Alpha-fetoprotein (AFP) is a protein produced in the liver of a developing fetus and used as a tumor marker to help detect and diagnose cancers of the liver, testicles, and ovaries. 3 Previous study considered AFP nearly useless in NPC patients since NPC did not produce AFP.…”

The Association of Epstein-Barr Virus With Cancer

“…These patients were followed for a seven-year span and the development of NPC was tracked through a local cancer registry. This study found that 30 of its participants were diagnosed with NPC and that risk of malignancy was positively correlated with increased plasma EBV DNA load [17]. While the two studies mentioned above dealt with diagnosis, a 2003 study added prognosis into the mix.…”

The Promise of Circulating Tumor DNA in Head and Neck Cancer

“…The Epstein–Barr virus has been associated with several different malignancies, including nasopharyngeal carcinoma (NPC) [ 49 , 50 ]. It has been determined to affect around 85–95% of the healthy population and has been endemically linked with NPC in Southeast Asia [ 44 ].…”