Zheng Xiao-Hui, Lu Li-Xia, Li Xi-Zhao, Jia Wei-Hua
Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Cancer Sci. 2015 Sep;106(9):1196-201. doi: 10.1111/cas.12718. Epub 2015 Jul 14.
Nasopharyngeal carcinoma (NPC) is highly incident in southern China, where 40% of world's new cases arise each year. Detection of Epstein-Barr virus (EBV) DNA load in nasopharyngeal (NP) brush/swab samples has gradually been established as a method for diagnosis of NPC. However, its applicable value in NPC diagnosis has never been investigated in southern China. It is important to explore whether such a test could be applicable to our local population. A total of 245 consecutive participants undergoing NP brushing examination were recruited to obtain the NP brushing samples in this study. Quantitative PCR assays were used to obtain the EBV DNA load. Mann-Whitney, ANOVA and receiver operating characteristic tests were used to analyze its diagnostic value. NP brushing samples from NPC patients showed extremely high levels of EBV DNA load (mean = 46360 copy/ng DNA) compared to its expression from non-NPC control (mean = 28 copy/ng DNA) and high-risk control (mean = 50 copy/ng DNA) groups. It produced 96% sensitivity and 97% specificity, at the COV = 225 copy/ng DNA. Furthermore, EBV DNA load could reflect disease progress. Our data showed a better performance of EBV DNA load in NP brushing samples compared with an initial biopsy, immunoglobulin A (IgA) antibody titers to viral capsid antigen in serum and EBV DNA load in plasma. Detection of EBV DNA load in NP brushing samples could be an effective supplement for NPC diagnosis. Being minimally invasive and low cost, NP brush sampling combined with EBV DNA detection demonstrates great potential for screening high-risk populations for NPC.
鼻咽癌（NPC）在中国南方高发，每年全球40%的新发病例出现在此地。检测鼻咽（NP）刷检/拭子样本中的爱泼斯坦-巴尔病毒（EBV）DNA载量已逐渐成为一种诊断NPC的方法。然而，其在NPC诊断中的应用价值在中国南方从未得到研究。探索这种检测方法是否适用于我们当地人群很重要。本研究共招募了245名连续接受NP刷检的参与者以获取NP刷检样本。采用定量PCR检测法获取EBV DNA载量。使用曼-惠特尼检验、方差分析和受试者工作特征检验分析其诊断价值。与非NPC对照组（平均 = 28拷贝/纳克DNA）和高危对照组（平均 = 50拷贝/纳克DNA）相比，NPC患者的NP刷检样本显示出极高水平的EBV DNA载量（平均 = 46360拷贝/纳克DNA）。在病毒载量临界值（COV）= 225拷贝/纳克DNA时，其敏感性为96%，特异性为97%。此外，EBV DNA载量可反映疾病进展。我们的数据显示，NP刷检样本中的EBV DNA载量比初次活检、血清中病毒衣壳抗原的免疫球蛋白A（IgA）抗体滴度以及血浆中的EBV DNA载量表现更好。检测NP刷检样本中的EBV DNA载量可能是NPC诊断的有效补充。NP刷检采样结合EBV DNA检测具有微创和低成本的特点，在筛查NPC高危人群方面显示出巨大潜力。
