Epstein-Barr (EBV) infection and presence of a nasopharyngeal cancer (NPC) case in the family increases the risk of developing NPC. Aberrant anti-EBV immunoglobulin A (IgA) antibodies (EBV-IgA) may be present in the sera of non-cancer individuals and predict NPC. Limited studies report the presence of EBV-IgA antibodies within non-cancer individuals in Indonesia where the disease is prevalent. This study aimed at exploring whether EBV-IgA was found more frequently among first degree relatives of NPC patients and individuals presenting with chronic symptoms in the head and neck area compared to healthy controls. A total of 967 non-cancer subjects were recruited, including 509 family members of NPC cases, 196 individuals having chronic complaints in the head and neck region, and 262 healthy donors of the local blood bank. Sera were analyzed using a standardized peptide-based EBV-IgA ELISA. Overall, 61.6% of all individuals had anti-EBV IgA reactivity equal to or below cut off value (CoV). Seroreactivity above CoV was significantly higher in females (38.7%) compared to males (28.7%) (p = 0.001). Older individuals had more seroreactivity above CoV (42.5%) than the younger ones (26.4%) (p< 0.001). Seroprevalence was significantly higher in family members of NPC patients (41.7%), compared to 32.7% of individuals with chronic head and neck problems (p = 0.028) and 16.4% healthy blood donors (p< 0.001). As conclusion, this study showed a significant higher seroprevalence in healthy family members of NPC cases and subjects presenting with chronic symptoms in the head and neck area compared to healthy individuals from the general community. This finding indicates that both groups have elevated risk of developing NPC and may serve as targets for a regional NPC screening program.

Table of contentsA1 Hope and despair in the current treatment of nasopharyngeal cancerIB TanI1 NPC international incidence and risk factorsEllen T ChangI2 Familial nasopharyngeal carcinoma and the use of biomarkersChien-Jen Chen, Wan-Lun Hsu, Yin-Chu ChienI3 Genetic susceptibility risk factors for sporadic and familial NPC: recent findingsAllan HildesheimI5 Genetic and environmental risk factors for nasopharyngeal cancer in Southeast AsiaJames D McKay, Valerie Gaborieau, Mohamed Arifin Bin Kaderi, Dewajani Purnomosari, Catherine Voegele, Florence LeCalvez-Kelm, Graham Byrnes, Paul Brennan, Beena DeviI6 Characterization of the NPC methylome identifies aberrant epigenetic disruption of key signaling pathways and EBV-induced gene methylationLi L, Zhang Y, Fan Y, Sun K, Du Z, Sun H, Chan AT, Tsao SW, Zeng YX, Tao QI7 Tumor exosomes and translational research in NPCPierre Busson, Claire Lhuillier, Olivier Morales, Dhafer Mrizak, Aurore Gelin, Nikiforos Kapetanakis, Nadira DelhemI8 Host manipulations of the Epstein-Barr virus EBNA1 proteinSheila Mansouri, Jennifer Cao, Anup Vaidya, and Lori FrappierI9 Somatic genetic changes in EBV-associated nasopharyngeal carcinomaLo Kwok WaiI10 Preliminary screening results for nasopharyngeal carcinoma with ELISA-based EBV antibodies in Southern ChinaSui-Hong Chen, Jin-lin Du, Ming-Fang Ji, Qi-Hong Huang, Qing Liu, Su-Mei CaoI11 EBV array platform to screen for EBV antibodies associated with NPC and other EBV-associated disordersDenise L. Doolan, Anna Coghill, Jason Mulvenna, Carla Proietti, Lea Lekieffre, Jeffrey Bethony, and Allan HildesheimI12 The nasopharyngeal carcinoma awareness program in IndonesiaRenske Fles, Sagung Rai Indrasari, Camelia Herdini, Santi Martini, Atoillah Isfandiari, Achmad Rhomdoni, Marlinda Adham, Ika Mayangsari, Erik van Werkhoven, Maarten Wildeman, Bambang Hariwiyanto, Bambang Hermani, Widodo Ario Kentjono, Sofia Mubarika Haryana, Marjanka Schmidt, IB TanI13 Current advances and future direction in nasopharyngeal cancer managementBrian O’SullivanI14 Management of juvenile nasopharyngeal cancerEnis OzyarI15 Global pattern of nasopharyngeal cancer: correlation of outcome with access to radiotherapyAnne WM LeeI16 The predictive/prognostic biomarker for nasopharyngeal carcinomaMu-Sheng ZengI17 Effect of HLA and KIR polymorphism on NPC riskXiaojiang Gao, Minzhong Tang, Pat Martin, Yi Zeng, Mary CarringtonI18 Exploring the Association between Potentially Neutralizing Antibodies against EBV Infection and Nasopharyngeal CarcinomaAnna E Coghill, Wei Bu, Hanh Nguyen, Wan-Lun Hsu, Kelly J Yu, Pei-Jen Lou, Cheng-Ping Wang, Chien-Jen Chen, Allan Hildesheim, Jeffrey I CohenI19 Advances in MR imaging in NPCAnn D KingO1 Epstein-Barr virus seromarkers and risk of nasopharyngeal carcinoma: the gene-environment interaction study on nasopharyngeal carcinoma in TaiwanYin-Chu Chien, Wan-Lun Hsu, Kelly J Yu, Tseng-Cheng Chen, Ching-Yuan Lin, Yung-An Tsou, Yi-Shing Leu, Li-Jen Laio, Yen-Liang Chang, Cheng-Ping Wang, Chun-Hun Hua, Ming-Shiang Wu, Chu-Hsing Kate Hsiao, Jehn-Chuan ...

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Aim: Epstein-Barr virus (EBV) infection and family history are strong risk factors associated with undifferentiated nasopharyngeal carcinoma (NPC). The presence of aberrant immunoglobulin A (IgA) antibodies against specific EBV antigens in healthy individuals can be predictive of the disease. Unlike in familial NPC, very limited reports have explored the EBV IgA antibody presence within families of sporadic cases of NPC.The aim of this study is to determine whether EBV IgA was more frequently observed among healthy family members of sporadic cases of NPC compared to healthy non-family individuals. Methods: First-degree relatives of NPC patients (n = 508) were recruited in a home visite program. Non-family individuals (n= 284) were recruited from Yogyakarta blood bank. Sera from all individuals were tested in standardized peptide-based EBV IgA ELISA and a positive result of seroreactivity was defined as OD 450 >0.354, being the cutt-of value (CoV). Data on demographic variables were collected using a questionnaire through face-to-face interviews. Results: A total of 280 (35.4%) individuals showed seroreactivity of EBV IgA. A significant higher frequency was observed in the first-degree relatives of NPC cases than in non-family individuals (41.9% versus 21.2%, p< 0.001). In both groups, more female presented with higher seroreactivity compared to male (41.8% versus 30%, p= 0.007). More younger (≤ 40 years) and educated individuals presented with normal reactivity of EBV IgA ( p= 0.340 and < 0.001, respectively). Conclusions: Family members of NPC cases demonstrated higher level of EBV IgA seroreactivity compared to non-family individuals, implicating a suitability of screening program among this group. Disclosure: All authors have declared no conflicts of interest.

Intrauterine devices (IUDs) are the most commonly used long-term contraception due to their 98–99% effectiveness in preventing pregnancy. There are two types of IUD available in Indonesia, a copper-containing IUD and levonorgestrel-releasing IUD. IUD causes chronic inflammatory changes in the endometrium and fallopian tubes that inhibit fertilization and make a hostile environment for implantation. The increased number of endometrial leukocytes is fatal for sperm. In addition, levonorgestrel will inhibit ovulation. The use of an IUD is associated with side effects and complications. The most commonly met complications are IUD expulsion, displacement, translocation, and pregnancy. The average IUD translocation prevalence is 1.3/1000 which mainly occurs during insertion. Translocated IUD may further cause perforation of the bladder or intestines, intestinal obstruction, fistula formation, abscess, adhesion, undesired pregnancy, and chronic pelvic pain. Regardless of the type and location, the WHO recommends removal of the translocated IUD due to its potentially severe complications. Here, we present four cases of IUD translocation at Cipto Mangunkusumo National Hospital from 2020 to 2021, focusing on how to diagnose and the management to remove it.