Epstein-Barr Antibodies in Suspected Nasopharyngeal Carcinoma

Ho, Helen; Kwan, H. C.; Wu, Ping; Chan, S.K.; Ng, Margaret H.L.; Saw, Daisy

doi:10.1016/s0140-6736(78)91825-1

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…Patients with nasopharyngeal carcinoma usually exhibit high levels of antibodies directed against EBV‐specific antigens. In a previous study by Ho et al6, 7 93% of patients with nasopharyngeal carcinoma had elevated IgA level against the VCA antigen. Although the serological test is useful for patients with suspected NPC, its value in NPC screening is much less certain.…”

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confidence: 82%

Screening for family members of patients with nasopharyngeal carcinoma

Yau

Yung

et al. 2004

Int. J. Cancer

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Nasopharyngeal carcinoma (NPC) is well known for its peculiarly skewed distribution with highest incidence in Southern Chinese population. Familial aggregation is evident, hence screening for early detection is offered by oncology centers in Hong Kong to first-degree relatives of patients with NPC. During the period 1994 -2001, 929 family members were screened in our center. The screenees were advised to attend an annual examination that includes serological test against Epstein Barr Virus (EBV), physical examination to exclude cervical lymphadenopathy and cranial nerve palsy, and endoscopic examination of the nasopharyngeal region. Two different methods were used for the serology test: indirect immuno-fluorescent (IF) test for IgA against viral capsid antigen; and starting in 1997 enzyme-linked immunosorbent assay (ELIZA) against nuclear antigen and viral capsid antigen. Twelve cases of nasopharyngeal carcinoma were diagnosed, giving a detection rate of 5/1,155 (433/100,000) person-year for male and 7/1,404 (499/100,000) person-year for female participants observed. The corresponding average annual incidence in Hong Kong during this period was 24.1 and 9.6 per 100,000, respectively. Forty-one percent of these detected cases had Stage I disease, whereas only 2% of patients referred to the department for primary treatment presented with such early disease. Six cases were detected at first visit, and all were EBV-positive. Another 78 screenees with positive serology at first visit were followed up for 204 person years, and thus far NPC was detected in 3 after an interval of 6 -32 months. Of the 845 initially EBV-negative screenees followed up for 2,337 person-years, NPC was detected in 3 after an interval of 12-45 months. One showed sero-conversion at the time of diagnosis. We conclude that family members of known patients do show a substantially higher risk of developing NPC, and regular screening by current method improves the chance of early detection. © 2004 Wiley-Liss, Inc.Key words: nasopharyngeal carcinoma; family aggregation; screening Although rare in most parts of the world, nasopharyngeal carcinoma (NPC) is common in Southern China and parts of SouthEast Asia, 1 and the incidence is highest among the Cantonesespeaking residents. According to the Hong Kong Cancer Registry, it ranked 4th for males and 9th for females for new cancers. In 1999, there were 1,118 newly diagnosed cases and 371 deaths registered. The average annual age-standardized incidence rate is 24.1/100,000 for males and 9.6/100,000 for females. 2 Epstein Barr Virus (EBV) has long been implicated in the pathogenesis of NPC. 3 Old et al. 4 first made the association of EBV with NPC using immunodiffusion when patients with undifferentiated NPC showed elevated IgG and IgA antibody titers against EA-D (early antigen-diffuse) and VCA (viral capsid antigen). Using in situ hybridization techniques, EBV DNA has also been confirmed in NPC tumour cells. 5 Patients with nasopharyngeal carcinoma usually exhibit high levels of antibodies directed again...

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confidence: 82%

Screening for family members of patients with nasopharyngeal carcinoma

Yau

Yung

et al. 2004

Int. J. Cancer

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“…This latent EBV infection in tumor cells also induces a wide variety of specific immunological responses. Past study by Ho [9,10] revealed that 93% of patient with nasopharyngeal carcinoma had elevated Immunoglobulin A (IgA) level against the viral capsid antigen (VCA) of EBV. EBV serology testing therefore appears to be a suitable screening tool.…”

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confidence: 99%

Outcomes of nasopharyngeal carcinoma screening for high risk family members in Hong Kong

Choi

Lee

et al. 2009

Familial Cancer

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We undertook a large retrospective study to evaluate the impact of screening family members of NPC patients with Epstein Barr Virus (EBV) serology. 1,199 asymptomatic family members of NPC patients were entered into the annual screening program with EBV serology and nasopharyngoscopy between 1994 and 2005. Eighteen participants of our screening program developed NPC; 17 of them were treated in our institute, of whom 16 were detected in screening. The sensitivity and specificity of EBV serology were 83.3 and 87.0%, respectively, and for the program they were 88.9 and 87.0%, respectively. Stage distributions and survival outcomes of the 17 cases were compared with that of 1,185 consecutive symptomatic patients diagnosed in the same period through general referral. It was found that the screening program resulted in early detection of cancer, with 59% presenting at early stage (stage I: 41%, stage II: 18%) compared to 24% (stage I: < 1%, stage II: 23%) of symptomatic cancers (P < 0.001), and a significant improvement in disease-free survival (P = 0.04). The cancer specific survival and overall survival rate at 5-year are also higher (92 vs. 77% and 92 vs. 70%, respectively), though they fail to reach statistical significance. In conclusion, screening asymptomatic family members of NPC patients annually leads to earlier detection of NPC and clinically valuable survival advantage among these family members. A larger sample size is needed to confirm its full potential in survival benefit.

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“…[2], было показано, что для диагностики РНГ могут быть успешно использованы IgA-антитела к вирусному капсидному антигену (ВКА) ВЭБ (ВКА/ВЭБ) в титрах 1:10 и выш. Несколько менее выраженной, но достаточной диагностической ценностью обладали также IgG-и IgA-антитела к раннему антигену (РА) вируса [3,4].…”

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Diagnostic value of the Epstein-Barr virus serological markers in patients with nasopharyngeal carcinoma in cases of undetectable primary tumor location

Gurtsevitch

Senyuta

Lomaya

et al. 2016

Problems of Virology

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The goal of this work was to describe a method for diagnosis of the non-keratinizing nasopharyngeal carcinoma (nNPC) in cases of the undetectable primary tumor location. The method is based on evaluation of IgG and IgA antibody levels to the capsid (VCA) and early antigens (EA) of the Epstein-Barr virus (EBV). The diagnosis of nNPC is established by a so-called decision rule. The latter was created by mathematical processing of the method of multifactor analysis of the results of anti-EBV antibody testing of 72 patients with clinically and morphologically confirmed nNPC and 72 patients with other head and neck benign tumors (OHNT) not associated with EBV, which were tested as a control group. The diagnostic value of the decision rule which was tested in the group of 77 patients with confirmed nNPC and 231 patients of a control group was high. The numbers of false negative and false positive cases were equal to 5.2% (4/77) and 6.5% (17/231), respectively. Among 32 patients with undetectable primary tumors the decision rule was able to identify 11 cases of nNPC. This diagnosis later was confirmed by morphological and instrumental methods of study. Only in two cases, false negative result was obtained (2/32; 6.3%) indicating that the serological diagnostics of nNPC with the decision rule is highly specific but not exact. Thus, the data obtained allowed us to conclude that the serological testing of EBV specific antibody evaluated by the decision rule can be recommended as an important test supplementing the standard methods of pdNPC diagnostics including cases with undetected primary tumor location.

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Epstein-Barr Antibodies in Suspected Nasopharyngeal Carcinoma

Cited by 7 publications

References 9 publications

Screening for family members of patients with nasopharyngeal carcinoma

Screening for family members of patients with nasopharyngeal carcinoma

Outcomes of nasopharyngeal carcinoma screening for high risk family members in Hong Kong

Diagnostic value of the Epstein-Barr virus serological markers in patients with nasopharyngeal carcinoma in cases of undetectable primary tumor location

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