The diagnostic value of EBV-DNA and EBV-related antibodies detection for nasopharyngeal carcinoma: a meta-analysis

Liu, Weixing; Chen, Gui; Gong, Xin; Wang, Yingqi; Zheng, Yaoming; Liao, Xiao; Liao, Wenjing; Song, Lijuan; Xu, Jianing; Zhang, Xiaowen

doi:10.1186/s12935-021-01862-7

Cited by 41 publications

(34 citation statements)

References 63 publications

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“…Even we utilized a cutoff at the LLOQ, only 21.8% NPC cases with EBV seropositive are detectable by plasma EBV DNA in this cohort, that is nearly 80% NPC cases would be missed. Similar to our result, several previous population-based cross-sectional screening studies have also reported the sensitivity of plasma EBV DNA (56.4–73.0%) is inferior to EBV antibody testing alone (> 90%) in NPC screening [ 21 ].…”

Section: Discussionsupporting

confidence: 91%

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

Chen

Wang

et al. 2021

BMC Cancer

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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.

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Section: Discussionsupporting

confidence: 91%

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

Chen

Wang

et al. 2021

BMC Cancer

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“…Previous studies have shown no correlation between the viral load of EBV DNA and levels of serum antibodies against EBV in NPC patients. 46,47 In the present study, we detected a correlation between the plasma viral load of EBV DNA and serum IgA antibody against EBV VCA, indicating that the viral load of EBV DNA appears 48 Our data showed a remarkable decline in HSP90α level among NPC patients with a good prognosis, and the plasma HSP90α level increased with the disease severity, suggesting that elevated HSP90α level may predict the migration or aggravation of NPC. In addition, our findings confirm that HSP90α has a potential as a biomarker for NPC, and high HSP90α level may trigger tumor development and progression.…”

supporting

confidence: 56%

Performance of Plasma HSP90α, Serum EBV VCA IgA Antibody and Plasma EBV DNA for the Diagnosis and Prognosis Prediction of Nasopharyngeal Carcinoma

Qian¹,

Guo²,

Chen³

et al. 2021

CMAR

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The aim of this study was to evaluate the effectiveness of Epstein-Barr virus (EBV) VCA-IgA antibody, EBV DNA and HSP90α alone or in combinations for the diagnosis and prognostic prediction of nasopharyngeal carcinoma (NPC). Methods: A total of 113 treatment-naïve patients with NPC and 40 healthy controls were enrolled. Plasma HSP90α and serum EBV VCA IgA antibody were detected using ELISA, and plasma EBV DNA was quantified using qPCR assay. The effectiveness of plasma HSP90α level, serum EBV VCA IgA antibody and plasma EBV DNA was examined in the diagnosis and prognosis prediction of NPC. Results: Higher plasma HSP90α, serum EBV VCA IgA antibody and plasma viral load of EBV DNA were detected in NPC patients than in healthy controls (P < 0.001). The plasma HSP90α levels, serum EBV VCA IgA antibody titers and plasma viral load of EBV DNA were significantly greater in NPC patients with stages III and IV than in those with stages I and II (P < 0.001), and significantly lower plasma HSP90α levels, serum EBV VCA IgA antibody titers and plasma viral load of EBV DNA were found in the good prognosis group than in the poor prognosis group post-treatment (P < 0.05). The area under representative operating curves (AUCs) of plasma HSP90α, serum EBV VCA IgA antibody and plasma EBV DNA alone and in combination were 0.884, 0.841, 0.934 and 0.954 for the diagnosis of NPC, respectively. Univariate and multivariate Cox proportional hazards regression analyses identified HSP90α as an independent prognostic factor for NPC. Conclusion:The combination of plasma HSP90α, serum EBV VCA IgA antibody and plasma EBV DNA shows high diagnostic performance for NPC, and plasma HSP90α may be a potential marker for diagnosis and prognosis prediction of NPC.

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“…Because most research has previously focused on EBV-DNA, our present study investigated the prognostic values of other indicators for NPC. Our previous study reported that EA-IgA can be used for the diagnosis of NPC [ 9 ]. Combined with data from this meta-analysis, we show that these biomarkers can be used as both diagnostic and prognostic indicators, because these indicators can be detected during the EBV infection cycle.…”

Section: Discussionmentioning

confidence: 99%

“…The value of anti-EBV IgA antibodies (e.g., EA-IgA, VCA-IgA) and other EBV-related antibodies for NPC diagnosis has been reported [ 8 ]. Our previous work indicates that EBV-DNA and EBV-related antibodies have diagnostic value [ 9 ]. Further to our previous report, this meta-analysis was conducted to shed light on the prognostic value of these biomarkers in NPC patients through a literature search of published studies, data extraction, quality assessment and statistical processing.…”

Section: Introductionmentioning

confidence: 99%

Serum EA-IgA and d-dimer, but not VCA-IgA, are associated with prognosis in patients with nasopharyngeal carcinoma: a meta-analysis

et al. 2021

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Background Patients with nasopharyngeal cancer (NPC) differ in prognosis, even at the same stage; therefore, new biomarkers are urgently required to identify early-stage NPC patients at high risk of poor prognosis. Although Epstein–Barr virus (EBV) DNA has been used for prognosis, the value of many other biomarkers expressed during the infection cycle of EBV remains unclarified. This study aimed to evaluate the prognostic potential of EA-IgA, VCA-IgA and d-dimer in patients with NPC. Methods Electronic databases, including PubMed, Embase and Web of Science, were searched up to February 1, 2021. Pooled data were extracted from studies that evaluated the relationship between NPC and overall survival (OS), distant metastasis-free survival (DMFS) or disease-free survival (DFS) and then were subjected to a meta-analysis. Results Nine studies with 5729 patients were included in this meta-analysis. In patients with NPC, EA-IgA levels significantly predicted OS (HR = 1.63, 95% CI 1.07–2.48). d-Dimer levels significantly predicted OS (HR = 1.75, 95% CI 1.24–2.47) and DMFS (HR = 1.91, 95% CI 1.31–2.79). However, high levels of VCA-IgA were not associated with OS (HR = 1.24, 95% CI 0.95–1.60), DMFS (HR = 1.41, 95% CI 0.92–2.17) or DFS (HR = 2.39, 95% CI 0.78–7.26). Conclusions The present findings reveal that EA-IgA and d-dimer, but not VCA-IgA, can be used as prognostic biomarkers in NPC.

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The diagnostic value of EBV-DNA and EBV-related antibodies detection for nasopharyngeal carcinoma: a meta-analysis

Cited by 41 publications

References 63 publications

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

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

Performance of Plasma HSP90α, Serum EBV VCA IgA Antibody and Plasma EBV DNA for the Diagnosis and Prognosis Prediction of Nasopharyngeal Carcinoma

Serum EA-IgA and d-dimer, but not VCA-IgA, are associated with prognosis in patients with nasopharyngeal carcinoma: a meta-analysis

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