WU Lijuan , ZHANG Li , ZHAO Yi , HUANG Xinyi , ZHOU Juan , DING Liu , PENG Wu , ZHUANG Jie , ZHOU Wenjing , LU Xiaojun , CHEN Jie
  • Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
CHEN Jie, Email: chenjie_wch@163.com
Nasopharyngeal carcinoma; Epstein-Barr virus; DNA test; Prognosis
10.7507/1002-0179.201909175
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Objective To explore the application value of plasma Epstein-Barr virus (EBV) DNA test in the clinical diagnosis of patients with nasopharyngeal carcinoma in non-high-incidence areas of Southwest China and its significance for monitoring patients after treatment. Methods A total of 235 patients diagnosed with non-keratinized nasopharyngeal carcinoma between January 2014 and December 2015 were retrospectively collected. The plasma EBV-DNA test rate of the nasopharyngeal carcinoma patients before treatment, the positive rates of the plasma EBV-DNA test before treatment and within 6 months of treatment, and the relationship between the positivity of plasma EBV-DNA within 6 months of treatment and the prognosis of nasopharyngeal carcinoma were analyzed. Results The plasma EBV-DNA test rate of the nasopharyngeal carcinoma patients before treatment was 69.79% (164/235), with a positive rate of 90.85% (149/164). A total of 131 patients were tested for EBV-DNA within 6 months of treatment, whose positive rate was 89.31% (117/131) before treatment and 21.37% (28/131) within 6 months of treatment, respectively, with a statistically significant difference (P<0.001). Comparing the prognosis of EBV-DNA positive patients and negative patients within 6 months of treatment, the difference in 3-year recurrence rate between the two groups was not statistically significant (10.71% vs. 3.88%, P=0.341); however, the 3-year metastasis rate (21.43% vs. 4.85%, P=0.016) and the 3-year disease progression rate (32.14% vs. 6.80%, P=0.001) of the EBV-DNA positive patients were higher than those of the EBV-DNA negative patients, and the log-rank test slao showed that the 3-year progression-free survival rate (67.86% vs. 93.20%, P<0.001) and the 3-year metastasis-free survival rate (78.57% vs. 95.15%, P=0.004) of the EBV-DNA positive patients were lower than those of the EBV-DNA negative patients. There was no statistically significant between-group difference in the 3-year progression-free survival curve when grouped by age, gender, or TNM staging (P>0.05).Conclusions For patients with non-keratinized nasopharyngeal carcinoma in non-high-incidence areas of Southwest China, EBV-DNA detection is important for the screening and diagnosis of nasopharyngeal carcinoma, and the positivity of EBV-DNA test within half a year of treatment is an important factor affecting the prognosis and progression of patients. Plasma EBV-DNA levels should be monitored regularly before and after treatment.

Citation： WU Lijuan, ZHANG Li, ZHAO Yi, HUANG Xinyi, ZHOU Juan, DING Liu, PENG Wu, ZHUANG Jie, ZHOU Wenjing, LU Xiaojun, CHEN Jie. Clinical value of plasma Epstein-Barr virus DNA test in patients with nasopharyngeal carcinoma in non-high-incidence area. West China Medical Journal, 2021, 36(8): 1032-1036. doi: 10.7507/1002-0179.201909175 Copy

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