Circulating Epstein-Barr virus DNA in serum of patients with lymphoepithelioma-like carcinoma of the lung: a potential surrogate marker for monitoring disease.
OBJECTIVE
The purpose of this work was to study the sera of patients with lymphoepithelioma-like carcinoma (LELC) of the lung for circulating EBV DNA.


METHODS
Prospectively collected serum samples from five female patients with advanced, inoperable LELC of the lung were measured for free circulating EBV DNA using a quantitative PCR technique. EBV-encoded small RNA (EBER)-1 was assayed in serial serum samples of three of the five patients, either from the start or during the initial phase of chemotherapy/radiotherapy until their terminal event or last follow-up. There was only a single-point sample for analysis in the fourth and fifth patients. Six other patients with LELC of the lung were also retrospectively identified, and their sera were tested for EBER-1 at either the first visit plus the last follow-up visit (n = 2), the first visit only (n = 2), or the last follow-up visit only (n = 2).


RESULTS
Prospectively collected serum samples from five patients and retrospectively collected serum samples from two patients who had clinical disease at initial serum measurement showed detectable levels of EBER-1. Retrospectively collected serum samples from four patients with no clinical disease had negative sera. There is consistent correlation between the clinical response to treatment and subsequent clinical course of LELC and serum EBER-1 levels in the three prospective patients with longitudinal serum monitoring.


CONCLUSIONS
This study shows for the first time that free EBV DNA can be detected in the serum of patients with LELC of the lung and further suggests the feasibility of its use for monitoring response to therapy in advanced cases.
Ngan
Roger K C
RK
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, China. ngankc@ha.org.hk
Yip
Timothy T C
TT
Cheng
Wai-Wai
WW
Chan
John K C
JK
Cho
William C S
WC
Ma
Victor W S
VW
Wan
Kwong-Kee
KK
Au
Siu-Kie
SK
Law
Chun-Key
CK
Lau
Wai-Hon
WH
D000328:Adult; D000956:Antigens, Viral / Q000276:immunology; D014408:Biomarkers, Tumor / Q000097:blood; D002213:Capsid / Q000276:immunology; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000188:drug therapy / Q000532:radiotherapy; D004279:DNA, Viral / Q000097:blood*; D020031:Epstein-Barr Virus Infections / Q000097:blood* / Q000821:virology; D017809:Fatal Outcome; D004854:Herpesvirus 4, Human / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000532:radiotherapy; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000187:drug effects / Q000528:radiation effects; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
D000956:Antigens, Viral; D014408:Biomarkers, Tumor; D004279:DNA, Viral; C099537:Epstein-Barr virus encoded RNA 1; D007070:Immunoglobulin A; D012367:RNA, Viral