Levels of plasma Epstein-Barr virus DNA prior and subsequent to treatment predicts the prognosis of nasopharyngeal carcinoma

Abstract

Abstract. The level of Epstein-Barr virus DNA (EBV-DNA) in the plasma prior and subsequent to treatment is a reliable biomarker for the screening, diagnosis, monitoring and prognosis of nasopharyngeal carcinoma (NPC). The present retrospective study aimed to determine whether pre-and post-treatment levels of plasma EBV-DNA were predictive of survival in a large sample of patients with NPC. The level of plasma EBV-DNA in 637 NPC patients prior and subsequent to treatment was determined by quantitative polymerase chain reaction. The value of pre-and post-treatment plasma EBV-DNA in predicting the survival of NPC patients was then analyzed. The results revealed that pre-treatment plasma EBV-DNA loads were significantly higher in patients with NPC than those in healthy controls (P<0.001). The percentage of patients with positive plasma EBV-DNA was markedly higher prior to treatment (70.64%; median, 1150 copies/ml; range, 0-9.75x10 6 copies/ml) than following treatment (25.99%; median, 0 copies/ml; range, 0-3.83x10 6 copies/ml) (P<0.001). Patients with a high plasma EBV-DNA load presented with a higher clinical tumor classification, lymph node status, metastatic status and overall cancer stage. The risk of NPC relapse and mortality was higher in patients with pre-treatment plasma EBV-DNA levels of ≥1,500 copies/ml than that in patients with <1,500 copies/ml. Furthermore, the risk of relapse and mortality was higher in patients with positive post-treatment plasma EBV-DNA than in patients with negative post-treatment plasma EBV-DNA. Detectable post-treatment plasma EBV-DNA was the most significant prognostic factor to affect relapse-free survival, whilst metastasis was the prognostic factor with the greatest effect on overall survival. These data indicated that pre-and post-treatment levels of plasma EBV-DNA were able to predict the prognosis of NPC. This finding may provide novel references for research and clinical practice.

Long-Term Monitoring of Dynamic Changes in Plasma EBV DNA For Improved Prognosis Prediction of Nasopharyngeal Carcinoma

“…Multiple reports have shown that pre-and post-treatment plasma EBV DNA are prognostic factors for NPC progression and survival [5,[14][15][16][17][18], and these ndings are also con rmed in this study. However, these previous studies mainly focused on few time points, for example, pre-treatment and 3 months posttreatment [19].…”

“…Cell-free EBV DNA from NPC tumor cells can be detected in the plasma of NPC patients [5], and the plasma DNA load can re ect the tumor load and residual disease or subclinical metastases [6]. Therefore, EBV DNA is widely considered as a reliable biomarker for early screening, clinical staging, prognosis prediction, individualized treatment and follow-up monitoring in NPC [7][8][9][10][11][12][13].While multiple studies have reported that plasma EBV DNA could be used as a predictive marker for NPC prognosis [5,[14][15][16][17][18], however, these studies only measured plasma EBV DNA load at limited time points, such as pre-treatment and 3 months post-treatment. We suggested that a long-term monitoring of dynamic changes of plasma EBV DNA could improve its prognostic value in NPC.In a meta-analysis by Qu et al [19], plasma EBV DNA was measured primarily from day 1 to 3 months post-treatment.…”

Circulating human papillomavirus DNA as a surveillance tool in head and neck squamous cell carcinoma: A systematic review and meta‐analysis

“…Circulating tumour DNA (ctDNA) from virally induced cancers has previously been shown to be clinically useful as a diagnostic test for other oncovirus-driven cancers such as HBV-induced hepatocellular carcinoma 14 and Epstein-Barr virus (EBV)-induced nasopharyngeal carcinomas (NPC). 15,16 HPV-DNA has also been demonstrated to be present in blood of patients with HPV-induced cervical cancer but absent from patients with pre-cursor cervical lesions. 17,18 The great advantage of a biomarker for oncovirus-driven cancers is the specificity of the biomarker, which sets it apart from the ctDNA biomarkers proposed for use in other solid cancers.…”

Epstein-Barr Virus and Nasopharyngeal Carcinoma: Viral Markers for Diagnostics and Assessment of Clinical Status of Patients

“…В данном исследовании, которое проводилось в неэндемичном регионе (Россия), мы изучали клиническое значение серологических маркёров ВЭБ, титры IgA/ВКА-и IgG/ВКА-антител, а также показатели концентрации ДНК ВЭБ в плазме больных нРНГ до и после лечения, в состоянии ремиссии или рецидива. Полученные данные в целом согласуются с результатами исследований, проведённых в эндемичных по нРНГ регионах [41,42], где тестирование концентраций ДНК ВЭБ и титров IgA/ ВКА-антител в плазме широко используется в качестве диагностического и прогностического инструмента для определения рецидива и выживаемости больных нРНГ [43][44][45]. В наших исследованиях мы также показали высокую ценность показателей концентрации ДНК ВЭБ и титров антител IgA/ВКА (но не IgG/ВКА) в плазме для диагностики нРНГ и оценки клинического состояния болезни (ремиссии или рецидива).…”