TY - JOUR
T1 - Can Epstein-Barr virus DNA load in nasopharyngeal brushings or whole blood predict recurrent nasopharyngeal carcinoma in a non-endemic region?
T2 - A prospective nationwide study of the Dutch Head and Neck Oncology Cooperative Group
AU - Stoker, S.D.
AU - Wildeman, M.A.
AU - Novalic, Z.
AU - Fles, R.
AU - van der Noort, V.
AU - de Bree, R.
AU - Braunius, W.W.
AU - van den Broek, G.B.
AU - Kreike, B.
AU - Kross, K.W.
AU - Juwana, H.
AU - Ramayanti, O.
AU - Verkuijlen, S.A.W.M.
AU - de Boer, J.P.
AU - Greijer, A.E.
AU - Middeldorp, J.M.
AU - Tan, I.B.
PY - 2016/6
Y1 - 2016/6
N2 - This study estimated the value of quantitative measurements of EBV markers in the clinical management of nasopharyngeal carcinoma in a non-endemic area. The aim was to predict prognosis and detect recurrent and residual disease. In 72 patients, EBV DNA load in blood and nasopharyngeal brushes, and IgA VCA-p18 and EBNA1 in plasma were measured at different time points. At diagnosis and post-treatment, a cut-off value was used for detecting disease [positive (PPV) and negative (NPV) predictive value]. The markers were correlated as a continuous variable with tumor stage, disease-free survival (DFS) and overall survival (OS). The Cox hazard ratio model assessed hazard ratios. At diagnosis, the markers were above the COV in 45, 92, 85 and 83 % of the patients, respectively. Post-treatment, DNA load test in blood and brush had the best discriminating power (blood DNA load test: PPV 39 % and NPV 97 %, brush for local disease: PPV 75 % and NPV 99 %). Post-treatment, DNA load in blood was the best predictor for OS and DFS [hazard ratio 3.2 (95 % CI 1.51–3.5) and 2.3 (95 % CI 1.72–5.8)]. Assessing the EBV DNA load in blood has significant prognostic value, although the clinical value is for discussion. The EBV DNA load in the brush might improve early detection of local failures post-treatment.
AB - This study estimated the value of quantitative measurements of EBV markers in the clinical management of nasopharyngeal carcinoma in a non-endemic area. The aim was to predict prognosis and detect recurrent and residual disease. In 72 patients, EBV DNA load in blood and nasopharyngeal brushes, and IgA VCA-p18 and EBNA1 in plasma were measured at different time points. At diagnosis and post-treatment, a cut-off value was used for detecting disease [positive (PPV) and negative (NPV) predictive value]. The markers were correlated as a continuous variable with tumor stage, disease-free survival (DFS) and overall survival (OS). The Cox hazard ratio model assessed hazard ratios. At diagnosis, the markers were above the COV in 45, 92, 85 and 83 % of the patients, respectively. Post-treatment, DNA load test in blood and brush had the best discriminating power (blood DNA load test: PPV 39 % and NPV 97 %, brush for local disease: PPV 75 % and NPV 99 %). Post-treatment, DNA load in blood was the best predictor for OS and DFS [hazard ratio 3.2 (95 % CI 1.51–3.5) and 2.3 (95 % CI 1.72–5.8)]. Assessing the EBV DNA load in blood has significant prognostic value, although the clinical value is for discussion. The EBV DNA load in the brush might improve early detection of local failures post-treatment.
KW - Diagnostic markers
KW - Epstein-Barr virus
KW - Nasopharyngeal carcinoma
U2 - https://doi.org/10.1007/s00405-015-3620-y
DO - https://doi.org/10.1007/s00405-015-3620-y
M3 - Article
C2 - 25929413
SN - 0937-4477
VL - 273
SP - 1557
EP - 1567
JO - European Archives of Oto-Rhino-Laryngology
JF - European Archives of Oto-Rhino-Laryngology
IS - 6
ER -