Gurtsevitch V E, Senyuta N B, Ignatova A V, Lomaya M V, Kondratova V N, Pavlovskaya A I, Dushenkina T E, Maximovich D M, Smirnova K V, Mudunov A M, Lichtenstein A V
N. N. Blokhin Russian Cancer Research Center, Kashirskoe shosse 24, 115478 Moscow, Russia.
J Gen Virol. 2017 Aug;98(8):2118-2127. doi: 10.1099/jgv.0.000889. Epub 2017 Aug 8.
The Epstein-Barr virus (EBV) plays a key role in the development of undifferentiated nasopharyngeal carcinoma (uNPC). In uNPC endemic regions EBV-specific antibodies and plasma EBV DNA load are used as markers for the early detection of uNPC and monitoring of the disease. In non-endemic regions, such studies were practically not conducted. The aim of this study was to compare the clinical significance of EBV serological markers and plasma EBV DNA levels for uNPC patients in a non-endemic region, Russia. The results obtained indicate that both viral capsid antigen/immunoglobulin A (VCA/IgA) antibodies and plasma EBV DNA copies can effectively be used for nasopharyngeal carcinoma (NPC) diagnosis. Besides, plasma EBV DNA load was found to be a more sensitive marker of uNPC than VCA/IgA antibody titres, as it reflected the effect of the therapy in stages of remission and relapse of the disease more precisely. Our study, for the first time, demonstrates that the simultaneous use of plasma EBV DNA loads and VCA/IgA antibody levels are indispensable markers for uNPC in non-endemic regions: a serological marker can be more effectively used for NPC screening, but EBV DNA copies are better for monitoring the disease. However, both markers turned out to be practically unsuitable for assessing the clinical status of patients. Serological markers did not correlate with any signs of the tumour process estimated by tumour, node and metastasis (TNM) classification and the plasma EBV DNA loads correlated only with the size of the pathologically altered lymph nodes (N). Additional study is required to confirm these findings.
爱泼斯坦-巴尔病毒（EBV）在未分化鼻咽癌（uNPC）的发生发展中起关键作用。在uNPC流行地区，EBV特异性抗体和血浆EBV DNA载量被用作uNPC早期检测和疾病监测的标志物。在非流行地区，此类研究几乎未开展。本研究的目的是比较EBV血清学标志物和血浆EBV DNA水平在非流行地区俄罗斯uNPC患者中的临床意义。所得结果表明，病毒衣壳抗原/免疫球蛋白A（VCA/IgA）抗体和血浆EBV DNA拷贝数均可有效用于鼻咽癌（NPC）诊断。此外，发现血浆EBV DNA载量是uNPC比VCA/IgA抗体滴度更敏感的标志物，因为它能更精确地反映疾病缓解期和复发期治疗的效果。我们的研究首次表明，同时使用血浆EBV DNA载量和VCA/IgA抗体水平是非流行地区uNPC不可或缺的标志物：血清学标志物可更有效地用于NPC筛查，但EBV DNA拷贝数更适合疾病监测。然而，这两种标志物实际上均不适用于评估患者的临床状态。血清学标志物与根据肿瘤、淋巴结和转移（TNM）分类评估的肿瘤进展的任何体征均无相关性，而血浆EBV DNA载量仅与病理改变的淋巴结大小（N）相关。需要进一步研究以证实这些发现。
