Application of circulating plasma/serum EBV DNA in the clinical management of nasopharyngeal carcinoma.
Elevated levels of circulating cell-free Epstein-Barr virus (EBV) DNA have been detected in plasma and serum samples from nasopharyngeal cancer (NPC) patients by quantitative real time PCR (qPCR) test. This qPCR test for circulating EBV DNA was found to be useful in the clinical management of NPC patients. For instance, EBV DNA qPCR test has good sensitivity and specificity in the detection of NPC at disease onset. Increase of the viral DNA load was found in NPC patients at late stages of disease. High EBV DNA load at disease onset or detectable viral load post-treatment was associated with poor survival or frequent relapse in NPC patients. Residual EBV DNA load after primary treatment could be a useful indicator to justify adjuvant chemotherapy. The qPCR test might also be applied to define a poor prognostic group in patients at early stage (I/II) for implementing concurrent chemo-radiotherapy (chemo-RT) to improve patients' outcome. The test is also useful to monitor distant metastases or response to radiotherapy, chemo-RT or surgery. Supplementary tests, however, are needed to pick up EBV negative WHO type I NPC and test improvement is needed to increase sensitivity in detecting stage I disease and local recurrence.
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China. Electronic address: yiptc@ha.org.hk.
Timothy T C
TT
Yip
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China. Electronic address: ngankc@ha.org.hk.
Roger K C
RK
Ngan
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China.
Alvin H W
AH
Fong
Hong Kong Adventist Oncology Center, Lower basement, Hong Kong Adventist Hospital, 40 Stubbs Road, Hong Kong.
Stephen C K
SC
Law
D004279:DNA, Viral / Q000097:blood*; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D017403:In Situ Hybridization; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000821:virology*; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity
D004279:DNA, Viral
BamH1-W; Distant metastasis; EBER1; EBNA1; Epstein–Barr virus; Head and Neck cancer; Local recurrence; Nasopharyngeal Cancer; Plasma EBV DNA; TaqMan quantitative real time PCR