title: Quantitative analysis of cell-free Epstein-Barr virus DNA in plasma of patients with nonnasopharyngeal head and neck carcinomas.
abstract: OBJECTIVE
  We investigated the detectability of EBV DNA in the plasma of patients with non-nasopharyngeal head and neck carcinomas (NNHNC). Previous studies have shown that EBV is present in the tumor tissue of some NNHNC.
  
  
  METHODS
  We recruited 101 patients with NNHNC and 48 healthy controls. Blood samples were taken from controls and patients before treatment. Tumor tissue samples were tested for the presence of EBV in the first 69 patients by in situ hybridization for small EBV-encoded RNA (EBER). Plasma EBV DNA was measured by real-time quantitative PCR in patients and controls.
  
  
  RESULTS
  Squamous cell carcinoma (SCC) was the commonest histology (78 patients) followed by lymphoepithelial carcinoma (8 patients). EBER was detected in tumor cells in 7 of 69 patients tested. All of the EBER-positive tumors were lymphoepithelial carcinoma. Two controls (2 of 48; 4.2%) had detectable plasma EBV DNA. Plasma EBV DNA was detected in all of the patients with EBER-positive tumors, and in 23 of 94 (24.5%) patients with tumors of EBER-negative or unknown status. The proportion of plasma EBV DNA-positive cases in either group was significantly higher than that in the control group (P < 0.0027). Plasma EBV DNA concentrations in patients with EBER-positive tumors (median, 3827 copies/ml) were significantly higher than those in the controls (median, 0 copy/ml; P = 0.0001). Of patients with SCC, 21 (26.9%) had detectable plasma EBV DNA (median concentration, 34 copies/ml). Plasma EBV DNA concentrations in the whole group of patients with SCC (median, 0 copy/ml; interquartile range, 0-4 copies/ml) were also significantly higher than those in the controls (P = 0.001).
  
  
  CONCLUSIONS
  Our data indicate that plasma EBV DNA reflects tumoral EBER status, and it may be of use as a tumor marker for EBER-positive NNHNC. The biological and clinical significance of low levels of circulating EBV DNA in the minority of patients with EBER-negative tumors remain to be elucidated.
authors.affiliation: Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors.forename: Kwok Hung
authors.initials: KH
authors.lastname: Yu
authors.forename: Y M Dennis
authors.initials: YM
authors.lastname: Lo
authors.forename: Gary M
authors.initials: GM
authors.lastname: Tse
authors.forename: K C Allen
authors.initials: KC
authors.lastname: Chan
authors.forename: Amy B W
authors.initials: AB
authors.lastname: Chan
authors.forename: Katherine C K
authors.initials: KC
authors.lastname: Chow
authors.forename: Tony K F
authors.initials: TK
authors.lastname: Ma
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Vlantis
authors.forename: Sing Fai
authors.initials: SF
authors.lastname: Leung
authors.forename: C Andrew
authors.initials: CA
authors.lastname: van Hasselt
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Johnson
authors.forename: Anthony T C
authors.initials: AT
authors.lastname: Chan
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000473:pathology / Q000821:virology; D004279:DNA, Viral / Q000097:blood* / Q000235:genetics / Q000302:isolation & purification; D005756:Gastritis / Q000821:virology; D006258:Head and Neck Neoplasms / Q000097:blood / Q000473:pathology / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D009367:Neoplasm Staging; D016133:Polymerase Chain Reaction; D012016:Reference Values
chemical_list: D004279:DNA, Viral