Senyuta N B, Smirnova K V, Kondratova V N, Ignatova A V, Mudunov A M, Dushenkina T E, Liechtenstein A V, Gurtsevich V E
N.N. Blokhin National Medical Research Center of Oncology, Moscow, 115478, Russia.
N.I. Pirogov Russian National Research Medical University, Moscow, 117997, Russia.
Vopr Virusol. 2019;64(5):229-237. doi: 10.36233/0507-4088-2019-64-5-229-237.
The reasons of late diagnosis of nasopharyngeal carcinoma (NPC) are the long asymptomatic course of the pathological process, the anatomical structure of the nasopharynx, often small, visually and endoscopically undetectable tumor and other factors. It is proved that the Epstein-Barr virus (EBV) is an etiological agent in the most common undifferentiated non-keratinizing histological type of NPC (uNPC).
The aim of the work was to assess the significance of diagnostic markers of EBV (titers of humoral antibodies to the virus and the concentration of viral DNA in plasma) for the diagnosis of uNPC in a group of patients with metastatic lesions of the cervical lymph nodes without an identified localization of the primary tumor focus.
The material for the study was blood plasma of 83 patients with metastatic lesions of the cervical lymph nodes and not established localization of the primary tumor. Plasma samples were tested for the anti-EBV IgG and IgA antibody content and titers and the concentration of viral DNA.
The data obtained indicate that the parallel testing of blood plasma for EBV-specific antibodies and viral load is a useful tool for preliminary screening of uNPC patients. The final diagnosis is confirmed by the data of subsequent morphological and instrumental studies. Several examples also show that the concentration of viral DNA in the blood plasma of patients with uNPC reflects the effect of the therapy and the prognosis of the disease: remission, stabilization of the tumor process, relapse or metastasis.
Although the titers of virus-specific antibodies are found to reflect clinical manifestations of the disease less accurately than the plasma concentrations of viral DNA, serological markers are extremely important for the preliminary diagnostics of uNPC in cases of undetected primary tumor location. They are also useful for primary screening of this neoplasm among individuals at risk.
鼻咽癌（NPC）晚期诊断的原因包括病理过程无症状期长、鼻咽部解剖结构、肿瘤通常较小在视觉和内镜下难以检测以及其他因素。已证实，爱泼斯坦-巴尔病毒（EBV）是最常见的未分化非角化组织学类型鼻咽癌（uNPC）的病原体。
本研究的目的是评估EBV诊断标志物（针对该病毒的体液抗体滴度和血浆中病毒DNA浓度）对一组颈部淋巴结转移病变患者（原发肿瘤灶定位不明）诊断uNPC的意义。
研究材料为83例颈部淋巴结转移病变且原发肿瘤灶定位未明确的患者的血浆。检测血浆样本中抗EBV IgG和IgA抗体含量、滴度以及病毒DNA浓度。
所得数据表明，对血浆进行EBV特异性抗体和病毒载量的平行检测是初步筛查uNPC患者的有用工具。最终诊断通过后续形态学和影像学研究数据得以证实。几个例子还表明，uNPC患者血浆中病毒DNA浓度反映了治疗效果和疾病预后：缓解、肿瘤进程稳定、复发或转移。
尽管发现病毒特异性抗体滴度比血浆中病毒DNA浓度更不准确地反映疾病临床表现，但血清学标志物对于原发肿瘤位置未检测到的情况下uNPC的初步诊断极为重要。它们对于在高危个体中对这种肿瘤进行初步筛查也很有用。
