Li Ying, Wu Lishui, Huang Zongwei, Cai Sunqiu, Xu Siqi, Wang Jue, Yu Yuxin, Lai Jinghua, Hu Dan, Qiu Sufang
Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, 350014, China.
Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, China.
BMC Oral Health. 2025 Aug 23;25(1):1361. doi: 10.1186/s12903-025-06733-5.
Epstein-Barr virus-encoded small RNA (EBER) in situ hybridization is the primary biomarker assay employed to infer Epstein-Barr virus (EBV) involvement in nasopharyngeal carcinoma (NPC). However, discordance between EBER status and EBV DNA detection has been observed in certain NPC patients. This study aims to investigate the prognostic significance of EBER and EBV DNA status.
A total of 2,942 NPC patients with known EBV status, treated at our center between 2016 and 2022, were included in this analysis. Clinical characteristics and survival outcomes were compared between patients who had EBER-negative versus EBER-positive and who were matched in a 1:4 ratio. The Kaplan-Meier method was used to analyze survival data. The association between EBER-EBV DNA status and survival outcomes was assessed using multivariable analysis.
Among the cohort, 51 patients (1.7%) were EBER-negative, while 2,891 patients (98.3%) were EBER-positive. EBV-negative NPC was significantly associated with the keratinizing subtype (15.7% vs. 0.3%, P < 0.001). EBER-negative patients exhibited a higher propensity for locoregional recurrence compared to their EBER-positive counterparts, with a 5-year locoregional failure-free survival rate of 76.5% (95% CI, 63.3%-92.5%) versus 86.8% (95% CI, 85.0%-88.6%), respectively (P = 0.012). Multivariable analysis further identified a significant association between double-negative status (EBER-/EBV DNA-) and an increased risk of locoregional recurrence (HR: 4.368, 95% CI, 2.058-9.269, P < 0.001), compared to the double-positive one. These associations remained robust after adjustment for confounding factors and in repeated analyses of the matched cohort.
This study highlights the potential prognostic value of EBER and EBV DNA combinations in NPC. However, given the limited number of EBV-negative cases, further investigations are warranted to substantiate these findings.
爱泼斯坦-巴尔病毒编码的小RNA（EBER）原位杂交是用于推断爱泼斯坦-巴尔病毒（EBV）与鼻咽癌（NPC）相关性的主要生物标志物检测方法。然而，在某些NPC患者中已观察到EBER状态与EBV DNA检测结果不一致。本研究旨在探讨EBER和EBV DNA状态的预后意义。
本分析纳入了2016年至2022年在本中心接受治疗的2942例已知EBV状态的NPC患者。比较了EBER阴性与EBER阳性患者（按1:4比例匹配）的临床特征和生存结局。采用Kaplan-Meier方法分析生存数据。使用多变量分析评估EBER-EBV DNA状态与生存结局之间的关联。
在该队列中，51例患者（1.7%）为EBER阴性，而2891例患者（98.3%）为EBER阳性。EBV阴性的NPC与角化型显著相关（15.7%对0.3%，P<0.001）。与EBER阳性患者相比，EBER阴性患者局部区域复发的倾向更高，5年局部区域无失败生存率分别为76.5%（95%CI，63.3%-92.5%）和86.8%（95%CI，85.0%-88.6%）（P=0.012）。多变量分析进一步确定，与双阳性状态相比，双阴性状态（EBER-/EBV DNA-）与局部区域复发风险增加显著相关（HR：4.368，95%CI，2.058-9.269，P<0.001）。在调整混杂因素后以及对匹配队列进行重复分析时，这些关联仍然显著。
本研究强调了EBER和EBV DNA联合检测在NPC中的潜在预后价值。然而，鉴于EBV阴性病例数量有限，有必要进一步研究以证实这些发现。
