Kalpoe J S, Dekker P B Douwes, van Krieken J H J M, Baatenburg de Jong R J, Kroes A C M
Department of Medical Microbiology, Leiden University Medical Centre, Netherlands.
J Clin Pathol. 2006 May;59(5):537-41. doi: 10.1136/jcp.2005.030544. Epub 2006 Feb 17.
To evaluate the role of quantitative measurement of Epstein-Barr virus (EBV) DNA in the clinical management of nasopharyngeal carcinoma (NPC) in a low tumour risk area (western Europe).
22 consecutive Dutch NPC patients (11 europid) were studied. EBV DNA load in pretreatment and post-treatment plasma samples was determined. Three patients were also sampled at frequent intervals during treatment. RNA in situ hybridisation for the detection of EBV encoded RNAs (EBERs) was carried out on tumour biopsies of all cases.
All patients with EBER positive NPC (20/22) showed a positive EBV DNA load in plasma at the time of diagnosis (median EBV DNA level, 4.1 log(10) copies/ml). Patients with EBER negative NPC had no detectable EBV DNA in plasma. After treatment, complete remission was achieved in all cases and concurrently EBV DNA in plasma became undetectable in all patients. In the three longitudinally evaluated cases, EBV DNA load gradually declined towards undetectable levels within three weeks after start of treatment. Two patients developed a distant metastasis with concomitant increases in EBV viral load. In addition, one EBER positive patient developed an EBER negative metastasis in the neck during follow up and in this case EBV DNA load remained undetectable at the time of recurrence.
Plasma EBV DNA load measurement appears to be useful in a low tumour risk area. However, development of local recurrences may not always coincide with raised levels of EBV DNA.
评估定量检测爱泼斯坦-巴尔病毒（EBV）DNA在低肿瘤风险地区（西欧）鼻咽癌（NPC）临床管理中的作用。
对22例连续的荷兰NPC患者（11例白种人）进行研究。测定治疗前和治疗后血浆样本中的EBV DNA载量。3例患者在治疗期间也进行了频繁采样。对所有病例的肿瘤活检组织进行RNA原位杂交以检测EBV编码RNA（EBERs）。
所有EBER阳性的NPC患者（20/22）在诊断时血浆中EBV DNA载量均为阳性（EBV DNA水平中位数为4.1 log₁₀拷贝/ml）。EBER阴性的NPC患者血浆中未检测到EBV DNA。治疗后，所有病例均实现完全缓解，同时所有患者血浆中的EBV DNA均检测不到。在3例纵向评估的病例中，治疗开始后3周内EBV DNA载量逐渐下降至检测不到的水平。2例患者发生远处转移，同时EBV病毒载量增加。此外，1例EBER阳性患者在随访期间颈部出现EBER阴性转移，在复发时该病例的EBV DNA载量仍检测不到。
在低肿瘤风险地区，血浆EBV DNA载量检测似乎有用。然而，局部复发的发生可能并不总是与EBV DNA水平升高同时出现。
