title: Comparison of the prognostic impact of serum anti-EBV antibody and plasma EBV DNA assays in nasopharyngeal carcinoma.
abstract: OBJECTIVE
  Nasopharyngeal carcinoma (NPC) has been proven as an Epstein-Barr virus (EBV)-associated cancer. Serum anti-EBV antibodies and plasma EBV DNA have been investigated as surrogate markers for NPC. A comparison of the prognostic impacts of both assays has never been reported.
  
  
  METHODS
  Paired serum and plasma samples from 114 previously untreated NPC patients were collected and subjected to an immunofluorescence assay for immunoglobulin (Ig)A and IgG antibodies against the viral capsid antigen (VCA) and a real-time quantitative polymerase chain reaction assay for EBV DNA measurement. The effects of both assays on patient prognosis were thoroughly investigated.
  
  
  RESULTS
  Relapsed patients had significantly higher pretreatment EBV DNA concentration than patients without relapse (p = 0.0006). No associations of VCA-IgA (p = 0.9669) or VCA-IgG (p = 0.6125) were observed between patients with and without relapse. The 4-year overall survival (60.3% vs. 93.1%, p < 0.0001) and relapse-free survival rates (54.4% vs. 77.9%, p = 0.0009) were significantly lower in patients with higher pretreatment EBV DNA load than in those with lower EBV DNA load. Patients with persistently detectable EBV DNA after treatment had significantly worse 4-year overall (30.8% vs. 84.6%, p < 0.0001) and relapse-free survival rates (15.4% vs. 74.0%, p < 0.0001) than those with undetectable EBV DNA. The VCA-IgA and VCA-IgG titer could not predict survivals (all p > 0.1). Cox multivariate analyses also showed the same results.
  
  
  CONCLUSIONS
  Plasma EBV DNA is superior to serum EBV VCA antibodies in prognostic predictions for NPC.
authors.affiliation: Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei.
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Twu
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Wang
authors.forename: Wen-Miin
authors.initials: WM
authors.lastname: Liang
authors.forename: Jian-Sheng
authors.initials: JS
authors.lastname: Jan
authors.forename: Rong-San
authors.initials: RS
authors.lastname: Jiang
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Chao
authors.forename: Ying-Tai
authors.initials: YT
authors.lastname: Jin
authors.forename: Jin-Ching
authors.initials: JC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D000956:Antigens, Viral / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D036022:Capsid Proteins / Q000276:immunology; D004279:DNA, Viral / Q000097:blood*; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000276:immunology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009303:Nasopharyngeal Neoplasms / Q000276:immunology / Q000821:virology*; D016133:Polymerase Chain Reaction / Q000379:methods*; D011379:Prognosis
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D015415:Biomarkers; D036022:Capsid Proteins; D004279:DNA, Viral; C041788:Epstein-Barr viral capsid antigen; D007070:Immunoglobulin A; D007074:Immunoglobulin G