title: Early detection of nasopharyngeal carcinoma by plasma Epstein-Barr virus DNA analysis in a surveillance program.
abstract: BACKGROUND
  Nasopharyngeal carcinoma (NPC) is prevalent in Southeast Asia. Over the last decade, plasma Epstein-Barr virus (EBV) DNA has been developed as a tumor marker for NPC. In this study, the authors investigated whether plasma EBV DNA analysis is useful for NPC surveillance.
  
  
  METHODS
  In total, 1318 volunteers ages 40 to 60 years were prospectively recruited. Plasma EBV DNA and serology for viral capsid antigen immunoglobulin A (IgA) were measured. Participants who had detectable plasma EBV DNA or positive IgA serology underwent nasal endoscopic examination and a follow-up plasma EBV DNA analysis in approximately 2 weeks. All participants were followed for 2 years to record the development of NPC.
  
  
  RESULTS
  Three individuals with NPC were identified at enrolment. All of them were positive for EBV DNA and remained positive in follow-up analysis. Only 1 of those patients was positive for EBV serology. In 1 patient who had NPC with a small tumor confined to the mucosa, the tumor was not detectable on endoscopic examination. Because of a 2-fold increase in plasma EBV DNA on the follow-up analysis, that patient underwent magnetic resonance imaging, which revealed the tumor. Among the participants who did not have NPC but had initially positive plasma EBV DNA results, approximately 66% had negative EBV DNA results after a median of 2 weeks.
  
  
  CONCLUSIONS
  Plasma EBV DNA analysis proved useful for detecting early NPC in individuals without a clinical suspicion of NPC. Repeating the test in those who had initially positive results differentiated those with NPC from those who had false-positive results. Cancer 2013. © 2013 American Cancer Society.
authors: Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. allen@cuhk.edu.hk
authors: K C Allen
authors: KC
authors: Chan
authors: Emily C W
authors: EC
authors: Hung
authors: John K S
authors: JK
authors: Woo
authors: Paul K S
authors: PK
authors: Chan
authors: Sing-Fai
authors: SF
authors: Leung
authors: Franco P T
authors: FP
authors: Lai
authors: Anita S M
authors: AS
authors: Cheng
authors: Sze Wan
authors: SW
authors: Yeung
authors: Yin Wah
authors: YW
authors: Chan
authors: Teresa K C
authors: TK
authors: Tsui
authors: Jeffrey S S
authors: JS
authors: Kwok
authors: Ann D
authors: AD
authors: King
authors: Anthony T C
authors: AT
authors: Chan
authors: Andrew C
authors: AC
authors: van Hasselt
authors: Y M Dennis
authors: YM
authors: Lo
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D001210:Asia, Southeastern / Q000453:epidemiology; D004279:DNA, Viral / Q000097:blood / Q000302:isolation & purification*; D055088:Early Detection of Cancer; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral