Plasma Epstein-Barr virus DNA and risk of nasopharyngeal carcinoma in a prospective seropositive population.
Plasma Epstein-Barr virus DNA and risk of nasopharyngeal carcinoma in a prospective seropositive population.
复制标题
血浆 Epstein-Barr 病毒 DNA 与前瞻性血清阳性人群中鼻咽癌的风险
DOI：
10.1186/s12885-021-08408-0
复制
发表时间：
2021-06-01
期刊：
影响因子：
3.8
通讯作者：
Cao SM
中科院分区：
文献类型：
--
作者：
Chen WJ;Xu WN;Wang HY;Chen XX;Li XQ;Xie SH;Lin DF;Cao SM
目的：血浆eb病毒（EBV） DNA被认为是鼻咽癌（NPC）的生物标志物。然而，它在NPC发展中的长期作用尚不清楚。材料与方法采用实时荧光定量pcr检测2008年至2015年中国南方一个社区NPC筛查项目中EBV VCA-IgA和EBNA1-IgA血清阳性的1363名参与者的血浆EBV DNA水平。截至2016年底，通过积极随访方法和与当地癌症登记处的联系，确认了新的NPC病例。采用Cox比例风险回归分析计算血浆EBV DNA与鼻咽癌风险的风险比（hr）。结果30例患者在中位7.5年的随访期间被新诊断。在检测不到和≥1000拷贝/ml水平的参与者中，随着血浆EBV DNA载量从281.46到100744.47 / 100000人-年，NPC发病率增加；相应的累计发病率分别为1.73和50%。此外，在调整其他危险因素后，血浆EBV DNA负荷为鼻咽癌发展带来了独立风险，在3-999拷贝/ml时，HRs为7.63，在≥1000拷贝/ml时，HRs为39.79。然而，排除前2 ~ 3年发现的鼻咽癌病例后，HRs逐渐下降，排除前4年发现的病例后，HRs无统计学意义。结论血浆EBV DNA升高可预测鼻咽癌3年内的发病风险。监测血浆EBV DNA可作为基于EBV血清学抗体筛查鼻咽癌的补充方法。
ObjectivePlasma Epstein-Barr virus (EBV) DNA is considered a biomarker for nasopharyngeal carcinoma (NPC). However, its long-term role in NPC development is unclear.Materials and methodsA total of 1363 participants seropositive for EBV VCA-IgA and EBNA1-IgA in a community-based NPC screening program in southern China were tested for plasma EBV DNA levels by real-time qPCR between 2008 and 2015. New NPC cases were confirmed by active follow-up approach and linkage to local cancer registry through the end of 2016. Cox proportional hazards regression analysis was performed to calculate the hazard ratios (HRs) for NPC risk with plasma EBV DNA.ResultsThirty patients were newly diagnosed during a median 7.5 years follow-up. NPC incidence increased with the plasma EBV DNA load ranging from 281.46 to 10,074.47 per 100,000 person-years in participants with undetectable and ≥ 1000 copies/ml levels; the corresponding cumulative incidence rates were 1.73 and 50%. Furthermore, plasma EBV DNA loads conferred an independent risk for NPC development after adjustment for other risk factors, with HRs of 7.63 for > 3–999 copies/ml and 39.79 for ≥1000 copies/ml. However, the HRs decreased gradually after excluding NPC cases detected in the first 2 to 3 years and became statistically nonsignificant by excluding cases detected during the first 4 years.ConclusionElevated plasma EBV DNA can predict NPC risk over 3 years. Monitoring plasma EBV DNA can be used as a complementary approach to EBV serological antibody-based screening for NPC.