Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
J Med Virol. 2018 Jan;90(1):191-195. doi: 10.1002/jmv.24918. Epub 2017 Sep 11.
Epstein-Barr virus detection using nasopharyngeal swabs has been suggested as a potential screening test that could improve the specificity of current EBV-based serological assays. However, application requires insertion of the swab deep into the nasopharynx, a procedure not amenable to non-clinic screening. We reasoned that swabbing the more easily accessible nasal cavity might provide an appealing alternative for NPC detection. Patients > 18 years of age diagnosed with histologically confirmed NPC were recruited from the Otolaryngology Department at the National Taiwan University Hospital. ENT clinicians collected both nasal and nasopharyngeal swabs. EBV DNA and cellular beta-globulin DNA were quantified using quantitative PCR targeting a highly-conserved region of the BKRF1 gene. EBV DNA was detectable (non-zero) in all 34 nasopharyngeal swabs and above the positivity threshold of 1666 EBV copies in 30 (88.2%) patients. EBV DNA was detectable in 50% of 34 nasal swabs and above the positivity threshold in four (11.8%) patients. Average EBV DNA levels were >3-fold higher (P < 0.001) in nasopharyngeal compared to nasal swabs. Among the 17 NPC patients with detectable EBV DNA in both swab types, we observed correlation (P < 0.01) between EBV DNA measurements. Our data represent the first evaluation of EBV DNA collected from nasal swabs. Given current EBV DNA amplification techniques, nasopharyngeal swabs remain more sensitive than nasal swabs for NPC detection.
采用鼻咽拭子检测 Epstein-Barr 病毒（EBV）已被提议作为一种潜在的筛查试验，可提高基于 EBV 的血清学检测的特异性。然而，该检测需要将拭子深入插入鼻咽，这种操作不适用于非临床筛查。我们认为，擦拭更容易接触的鼻腔可能是 NPC 检测的另一种有吸引力的替代方法。从台湾大学医院耳鼻喉科招募了年龄在 18 岁以上、经组织学证实的 NPC 患者。耳鼻喉科临床医生收集了鼻咽和鼻腔拭子。使用针对 BKRF1 基因高度保守区域的定量 PCR 定量检测 EBV DNA 和细胞β-球蛋白 DNA。所有 34 个鼻咽拭子中均可检测到 EBV DNA（非零），30 名（88.2%）患者的 EBV DNA 超过 1666 拷贝的阳性阈值。34 个鼻腔拭子中有 50%可检测到 EBV DNA，4 名（11.8%）患者的 EBV DNA 超过阳性阈值。与鼻腔拭子相比，鼻咽拭子中的 EBV DNA 平均水平高出 3 倍以上（P < 0.001）。在两种拭子类型均可检测到 EBV DNA 的 17 名 NPC 患者中，我们观察到 EBV DNA 测量值之间存在相关性（P < 0.01）。我们的数据代表了对从鼻腔拭子中收集的 EBV DNA 的首次评估。考虑到目前 EBV DNA 扩增技术，与鼻腔拭子相比，鼻咽拭子仍然更敏感，更适合 NPC 检测。
