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Su S, Wang G, Ye X, Wang H, Chen Y, Song S, Yang Z. The role of 18 F-FDG PET/CT in detecting recurrence and metastasis in posttreatment nasopharyngeal carcinoma patients with elevated Epstein-Barr virus DNA. Nucl Med Commun 2025; 46:356-361. [PMID: 39838879 DOI: 10.1097/mnm.0000000000001954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2025]
Abstract
OBJECTIVE The objective of this study is to evaluate and compare the clinical utility of 18 F-fluoro-2-deoxy-d-glucose PET and computed tomography ( 18 F-FDG PET/CT) in detecting recurrence and metastasis in patients with nasopharyngeal carcinoma (NPC) who exhibit elevated levels of Epstein-Barr virus (EBV) DNA following treatment. METHODS A total of 103 patients with NPC were studied retrospectively. All patients were in remission following initial treatment. Elevated EBV DNA was found for the first time at review and 18 F-FDG PET/CT imaging was completed. The number of tracer lesions and the maximum standardized uptake value in the body region were recorded to evaluate the diagnostic ability of 18 F-FDG PET/CT. The final diagnosis was confirmed either through pathology or clinical follow-up lasting 6 months or longer. RESULTS Out of the 103 patients, 97 patients had a total of 434 lesions that were ultimately diagnosed as recurrent or metastatic. In patient-based analyses, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 18 F-FDG PET/CT imaging were 100%, 50%, 97%, and 100%, respectively. In lesion-based analyses, the sensitivity, specificity, PPV, and NPV of 18 F-FDG PET/CT imaging were 99.3%, 30.3%, 94.9%, and 83.3%, respectively. CONCLUSION 18 F-FDG PET/CT demonstrates potential value in detecting recurrence and metastasis of NPC.
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Affiliation(s)
- Shuting Su
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen,
| | - Ge Wang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen,
| | - Xiuhuan Ye
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen,
| | - Hao Wang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen,
| | - Yuxuan Chen
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen,
| | - Shaoli Song
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen,
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center,
- Department of Oncology, Shanghai Medical College, Fudan University,
- Department of Nuclear Medicine, Center for Biomedical Imaging, Fudan University and
- Department of Nuclear Medicine, Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
| | - Zhongyi Yang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen,
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center,
- Department of Oncology, Shanghai Medical College, Fudan University,
- Department of Nuclear Medicine, Center for Biomedical Imaging, Fudan University and
- Department of Nuclear Medicine, Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
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2
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Zang Y, Lu Y, Yu J, Dong Q, Shi Y, Ying G, Liang Z. FOXP3 inhibits proliferation and migration by competitively inhibiting YAP1 in nasopharyngeal carcinoma. Oral Oncol 2024; 159:107066. [PMID: 39413576 DOI: 10.1016/j.oraloncology.2024.107066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 09/18/2024] [Accepted: 09/28/2024] [Indexed: 10/18/2024]
Abstract
Hippo signalling is involved in the coordination of extracellular signals that control tissue homeostasis and organ size. Yes-associated protein 1 (YAP1) is regulated primarily by Hippo signalling through coactivation of transcription factors with GATA domains called TEADs. However, small-molecule orthosteric inhibitors of YAP1 are difficult to develop due to its tight binding to TEAD4 via a flat interface. Previous studies have shown that chlorpromazine (CPZ) can inhibit YAP1 expression. MTT, colony formation, wound healing, Transwell migration and Western blot assays were performed to explore how CPZ affects nasopharyngeal carcinoma (NPC) cells through FOXP3. In addition, immunofluorescence and live-cell imaging were used to detect YAP1 intracellular localization after CPZ administration. Through the HDOCK website, we predicted protein binding regions between FOXP3 and TEAD4. Western blot and co-IP experiments were used to verify the relationship between FOXP3 and YAP1. The UCSC Xena database, LinkedOmics database and KM plotter website were used to assess the prognostic value of FOXP3 in head and neck squamous cell carcinoma (HNSCC). Age, sex, pathological tumour-node-metastasis (pTMN) stage, grade, smoking status and FOXP3 expression were included in an overall survival nomogram model. Our findings revealed that FOXP3 has the ability to competitively interacts competitively with TEAD4 to inhibit YAP1 expression. By increasing FOXP3 expression, CPZ induces YAP1 nuclear export and phosphorylation, consequently suppressing NPC cell proliferation and migration. Collectively, our findings indicate that FOXP3 competitively binds TEAD4 to regulate YAP1 localization in the nucleus and cytoplasm to suppress NPC progression. Consequently, FOXP3 may be a prognostic indicator for HNSCC.
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Affiliation(s)
- Yiqing Zang
- Department of Otorhinolaryngology, Tianjin Medical University General Hospital, Tianjin 300052, PR China
| | - Yi Lu
- Department of Otorhinolaryngology, Tianjin Medical University General Hospital, Tianjin 300052, PR China
| | - Jiaxi Yu
- Department of Otorhinolaryngology, Tianjin Medical University General Hospital, Tianjin 300052, PR China
| | - Qiuping Dong
- Department of Cancer Cell Biology, Tianjin's Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, PR China
| | - Yue Shi
- Department of Cancer Cell Biology, Tianjin's Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, PR China
| | - Guoguang Ying
- Department of Cancer Cell Biology, Tianjin's Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, PR China.
| | - Zheng Liang
- Department of Otorhinolaryngology, Tianjin Medical University General Hospital, Tianjin 300052, PR China.
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Suryani L, Lee HPY, Teo WK, Chin ZK, Loh KS, Tay JK. Precision Medicine for Nasopharyngeal Cancer-A Review of Current Prognostic Strategies. Cancers (Basel) 2024; 16:918. [PMID: 38473280 DOI: 10.3390/cancers16050918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/02/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
Nasopharyngeal carcinoma (NPC) is an Epstein-Barr virus (EBV) driven malignancy arising from the nasopharyngeal epithelium. Current treatment strategies depend on the clinical stage of the disease, including the extent of the primary tumour, the extent of nodal disease, and the presence of distant metastasis. With the close association of EBV infection with NPC development, EBV biomarkers have shown promise in predicting treatment outcomes. Among the omic technologies, RNA and miRNA signatures have been widely studied, showing promising results in the research setting to predict treatment response. The transformation of radiology images into measurable features has facilitated the use of radiomics to generate predictive models for better prognostication and treatment selection. Nonetheless, much of this work remains in the research realm, and challenges remain in clinical implementation.
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Affiliation(s)
- Luvita Suryani
- Department of Otolaryngology-Head & Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Hazel P Y Lee
- Department of Otolaryngology-Head & Neck Surgery, National University Hospital, Singapore 119228, Singapore
| | - Wei Keat Teo
- Department of Otolaryngology-Head & Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Zhi Kang Chin
- Department of Otolaryngology-Head & Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Kwok Seng Loh
- Department of Otolaryngology-Head & Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Joshua K Tay
- Department of Otolaryngology-Head & Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
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4
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Lai R, Yeung DCM, Yeung ZWC, Hui TSC, Lam WKJ, Chan KCA, Ng CWK, To ZWH, Cho RHW, Chan CPL, Lai CCF, Leung NMW, Wong EWY, Chung JCK, Tsang RKY, Li KWS, Chow JCH, Cheung KKM, Chan JYK. Combining Transoral Nasopharyngeal Brush and Plasma Epstein-Barr Virus DNA in Detecting Locally Recurrent Nasopharyngeal Carcinoma. Otolaryngol Head Neck Surg 2023; 169:1208-1214. [PMID: 37232502 DOI: 10.1002/ohn.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To evaluate the sensitivities and specificities of Epstein-Barr virus (EBV) DNA in the detection of locally recurrent or persistent nasopharyngeal carcinoma (NPC) through nasopharyngeal (NP) brush biopsy and plasma, respectively, and whether a combination of both would be superior to the individual tests. STUDY DESIGN A case-control study was conducted from September 2016 to June 2022. SETTING A multicentre study at 3 tertiary referral centers in Hong Kong was conducted by the Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong. METHODS Twenty-seven patients with biopsy-confirmed locally recurrent NPC were recruited as study subjects. Magnetic resonance imaging was performed to rule out regional recurrence. The control group consisted of 58 patients with a prior history of NPC who were now disease-free based on endoscopic and imaging findings. Patients underwent both the transoral NP brush (NP Screen®) and blood for plasma Epstein-Barr DNA levels. RESULTS The sensitivity and specificity of the combined modalities were 84.62% and 85.19%, respectively. The positive predictive value was 73.33% and the negative predictive value was 92.0%. CONCLUSION The combination of NP brush biopsy and plasma EBV DNA is potentially an additional surveillance modality in detecting the local recurrence of NPC. Further study with a larger sample size would be required to validate the cutoff values.
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Affiliation(s)
- Ronald Lai
- Department of Ear, Nose and Throat, United Christian Hospital, Kwun Tong, Hong Kong SAR
| | - David Chun Man Yeung
- Department of Ear, Nose and Throat, Prince of Wales Hospital, Shatin, Hong Kong SAR
| | - Zenon Wing Chi Yeung
- Department of Ear, Nose and Throat, United Christian Hospital, Kwun Tong, Hong Kong SAR
| | - Thomas Sin Chun Hui
- Department of Ear, Nose and Throat, United Christian Hospital, Kwun Tong, Hong Kong SAR
| | - Wai Kei Jacky Lam
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
- Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
- State Key Laboratory of Translational Oncology, Sir Y. K. Pao Centre for Cancer, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
| | - Kwan Chee Allen Chan
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
- Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
- State Key Laboratory of Translational Oncology, Sir Y. K. Pao Centre for Cancer, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
| | - Cherrie Wing Kei Ng
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Zion Wing Hei To
- Department of Ear, Nose and Throat, United Christian Hospital, Kwun Tong, Hong Kong SAR
| | - Ryan Hung Wai Cho
- Department of Ear, Nose and Throat, United Christian Hospital, Kwun Tong, Hong Kong SAR
| | | | - Calvin Chee Fung Lai
- Department of Ear, Nose and Throat, Prince of Wales Hospital, Shatin, Hong Kong SAR
| | | | - Eddy Wai Yeung Wong
- Department of Ear, Nose and Throat, Prince of Wales Hospital, Shatin, Hong Kong SAR
| | | | - Raymond King Yin Tsang
- Department of Ear, Nose and Throat, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR
- Department of Otolaryngology-Head and Neck Surgery, National University of Singapore, Singapore City, Singapore
| | - Kenneth Wing Sum Li
- Department of Clinical Oncology, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong SAR
| | - James Chung Hang Chow
- Department of Clinical Oncology, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong SAR
| | - Ken Ka Man Cheung
- Department of Clinical Oncology, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong SAR
| | - Jason Y K Chan
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
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Tulalamba W, Ngernsombat C, Larbcharoensub N, Janvilisri T. Transcriptomic profiling revealed FZD10 as a novel biomarker for nasopharyngeal carcinoma recurrence. Front Oncol 2023; 12:1084713. [PMID: 36776376 PMCID: PMC9909960 DOI: 10.3389/fonc.2022.1084713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/28/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is a type of cancers that develops in the nasopharynx, the very upper part of the throat behind the nose. NPC is typically diagnosed in later stages of the disease and has a high rate of recurrence due to the location of the tumor growth site. In this study, we compared the gene expression profiles of NPC tissues from patients with and without recurrence to identify potential molecular biomarkers of NPC recurrence. METHODS Microarrays were used to analyze the expression of genes in 15 NPC tissues taken at the time of diagnosis and at the site of recurrence following therapeutic treatment. Pathway enrichment analysis was used to examine the biological interactions between the major differentially expressed genes. The target identified was then validated using immunohistochemistry on 86 NPC tissue samples. RESULTS Our data showed that the Wnt signaling pathway was enhanced in NPC tissues with recurrence. FZD10, a component of the Wnt signaling pathway, was significantly expressed in NPC tissues, and was significantly associated with NPC recurrence. CONCLUSION Our study provides new insights into the pathogenesis of NPC and identifies FZD10 as a potential molecular biomarker for NPC recurrence. FZD10 may be a promising candidate for NPC recurrence and a potential therapeutic target.
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Affiliation(s)
- Warut Tulalamba
- Siriraj Center of Research Excellence in Advanced Gene and Cell Therapy (Si-CORE-AGCT) and Thalassemia Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Chawalit Ngernsombat
- Division of Biochemistry, Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Noppadol Larbcharoensub
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tavan Janvilisri
- Department of Biochemistry, Faculty of Science, Mahidol University, Bangkok, Thailand
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6
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Rueda Domínguez A, Cirauqui B, García Castaño A, Alvarez Cabellos R, Carral Maseda A, Castelo Fernández B, Iglesias Rey L, Rubió-Casadevall J, Arrazubi V, Mesía R. SEOM-TTCC clinical guideline in nasopharynx cancer (2021). Clin Transl Oncol 2022; 24:670-680. [PMID: 35303267 PMCID: PMC8986714 DOI: 10.1007/s12094-022-02814-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 12/08/2022]
Abstract
Nasopharyngeal carcinoma (NPC) is distinct from other cancers of the head and neck in biology, epidemiology, histology, natural history, and response to treatment. Radiotherapy (RT) is the cornerstone of locoregional treatment of non-disseminated disease and the association of chemotherapy improves the rates of survival. In the case of metastatic disease stages, treatment requires platinum/gemcitabine-based chemotherapy and patients may achieve a long survival time.
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Affiliation(s)
- Antonio Rueda Domínguez
- Medical Oncology Intercenter Unit, Regional and Virgen de La Victoria University Hospitals, IBIMA, 29010 Málaga, Spain
| | - Beatriz Cirauqui
- Medical Oncology Department. Catalan Institut of Oncology - Badalona. B-ARGO Group, IGTP, Badalona, Spain
| | | | | | | | | | - Leticia Iglesias Rey
- Medical Oncology Service, Complejo Hospitalario Universitario de Ourense, Ourense, Spain
| | - Jordi Rubió-Casadevall
- Medical Oncology Department, Hospital Josep Trueta. Catalan Institute of Oncology, Girona, Spain
| | - Virginia Arrazubi
- Medical Oncology Service, Complejo Hospitalario de Navarra. IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Ricard Mesía
- Medical Oncology Department. Catalan Institut of Oncology - Badalona. B-ARGO Group, IGTP, Badalona, Spain
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7
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Circulating Plasma Epstein-Barr Virus DNA Load During the Follow-up Periods Predicts Recurrence and Metastasis in Nasopharyngeal Carcinoma. Cancer J 2022; 28:85-92. [PMID: 35333490 DOI: 10.1097/ppo.0000000000000581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Epstein-Barr virus DNA (EBV DNA) load has been identified as a prognostic factor in nasopharyngeal carcinoma (NPC), whereas the dynamic changes in the long period have not been explored. In this study, we evaluated EBV DNA kinetics and its role in the survival. METHODS We conducted a retrospective review of 900 NPC patients. Plasma EBV DNA levels were measured at various time points after treatment. The correlations of EBV kinetics with recurrence and metastasis were analyzed. After stratifying patients according to the EBV results, survival was compared using Kaplan-Meier estimates. Twelve- and 24-month landmark analyses for overall survival (OS) data were performed according to the EBV groups. RESULTS Patients with post-EBV of less than 2500 copies/mL achieved better survival than did those with higher ones. Furthermore, patients with continuously elevated EBV DNA expressed significantly poorer OS (hazard ratio [HR], 2.542, 95% confidence interval [CI], 2.077-3.111; P < 0.001), distant metastasis-free survival (HR, 2.970; 95% CI, 2.392-3.687; P < 0.001), locoregional-free survival (HR, 1.699; 95% CI, 1.072-2.692; P = 0.013), and progression-free survival (HR, 2.535; 95% CI, 1.987-3.233; P < 0.001) than did patients with continuously normal EBV or those with elevated levels at any time point. The 5-year OS with elevated EBV was lower than that of the remission group by using the 12- and 24-month landmark analysis. CONCLUSIONS Elevated EBV DNA after treatment was a better predictive indicator of survival than the baseline concentrations. Furthermore, continuously elevated EBV DNA after treatment indicated recurrence, metastasis, and unfavorable prognosis for NPC. In addition, there were consistent patterns of EBV DNA kinetics during long-term follow-up, which warrant further study.
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8
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Vasudevan HN, Yom SS. Nasopharyngeal Carcinoma and Its Association with Epstein-Barr Virus. Hematol Oncol Clin North Am 2021; 35:963-971. [PMID: 34187713 DOI: 10.1016/j.hoc.2021.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Nasopharyngeal carcinoma (NPC) is caused by Epstein-Barr virus (EBV) infection, yet incorporating measurement of EBV DNA levels into clinical practice remains a challenge. Here, we summarize the relationship between NPC and EBV infection before describing the use of cell-free DNA as a plasma biomarker in cancer. We then compare conventional polymerase chain reaction methods and emerging next-generation sequencing approaches for EBV viral load detection emphasizing their prognostic and predictive utility. We conclude by considering how assay standardization, novel molecular approaches, and alternative clinical specimens may be leveraged to bring EBV testing into the routine care of patients with NPC.
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Affiliation(s)
- Harish N Vasudevan
- Department of Radiation Oncology, University of California San Francisco, Helen Diller Cancer Research Building, 1450 3rd street, HD403, San Francisco, CA 94158, USA
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, Precision Cancer Medicine Building, 1825 4th Street, Suite L1101, San Francisco, CA 94158, USA.
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9
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Bossi P, Chan AT, Licitra L, Trama A, Orlandi E, Hui EP, Halámková J, Mattheis S, Baujat B, Hardillo J, Smeele L, van Herpen C, Castro A, Machiels JP. Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up †. Ann Oncol 2021; 32:452-465. [PMID: 33358989 DOI: 10.1016/j.annonc.2020.12.007] [Citation(s) in RCA: 208] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- P Bossi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - A T Chan
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - L Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori and University of Milan, Milan, Italy
| | - A Trama
- Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - E Orlandi
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - E P Hui
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - J Halámková
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - S Mattheis
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, Essen, Germany
| | - B Baujat
- Sorbonne University, APHP, Department of ENT - Head and Neck Surgery, Tenon Hospital, Paris, France
| | - J Hardillo
- Department of ENT - Head and Neck Surgery, Erasmus Medical Center Rotterdam, Rotterdam
| | - L Smeele
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - C van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A Castro
- Administration Board of Centro Hospitalar e Universitário do Algarve, Portugal
| | - J-P Machiels
- Institut Roi Albert II, Service d'Oncologie Médicale, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Clinique et Expérimentale (POLE MIRO), Université Catholique de Louvain, Brussels, Belgium
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10
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Chow VLY, Chan JYW, Wong STS, Wei WI. Recommendations for surgical management of recurrent nasopharyngeal carcinoma during COVID-19 pandemic. Laryngoscope Investig Otolaryngol 2020; 5:468-472. [PMID: 32596489 PMCID: PMC7314480 DOI: 10.1002/lio2.417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022] Open
Abstract
Nasopharyngeal carcinoma is endemic in southern parts of China including Hong Kong. Primary treatment entails radiotherapy ± chemotherapy depending on disease stage at presentation. Surgery is offered as a means of salvage for persistent and recurrent disease. Comprehensive preoperative work-up, careful patient selection, attention to details perioperation and multidisciplinary approach is essential in ensuring optimal outcomes after salvage surgery for recurrent nasopharyngeal carcinoma patients. Since the COVID-19 outbreak, we are faced with unprecedented challenges with priorities of care and resources being shifted to combat the virus. These include patient selection and timing of treatment, while preventing disease transmission to heath care providers. Practices and recommendations made in this document are intended to support safe clinical practice and efficient use of resources during this challenging time.
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Affiliation(s)
- Velda Ling Yu Chow
- Division of Head and Neck Surgery, Department of SurgeryUniversity of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary HospitalHong Kong SARChina
| | - Jimmy Yu Wai Chan
- Division of Head and Neck Surgery, Department of SurgeryUniversity of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary HospitalHong Kong SARChina
| | - Stanley Thian Sze Wong
- Division of Head and Neck Surgery, Department of SurgeryUniversity of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary HospitalHong Kong SARChina
| | - William Ignace Wei
- Division of Head and Neck Surgery, Department of SurgeryUniversity of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary HospitalHong Kong SARChina
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11
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Peng H, Li Z, Long Y, Li J, Liu Z, Zhou R. Clinical value of a plasma Epstein-Barr virus DNA assay in the diagnosis of recurrent or metastatic nasopharyngeal carcinoma: a meta-analysis. Biosci Rep 2019; 39:BSR20190691. [PMID: 31484795 PMCID: PMC6753325 DOI: 10.1042/bsr20190691] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/15/2019] [Accepted: 09/03/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To evaluate the diagnostic value of Epstein-Barr virus (EBV) DNA in nasopharyngeal carcinoma (NPC) patients with locoregional or distant recurrence. METHODS Articles related to the diagnosis of recurrent or metastatic NPC by the detection of EBV DNA in plasma or serum were retrieved from different databases. Sensitivity, specificity, summary receiver operating characteristic (SROC) curves, and likelihood ratios were pooled to assess the diagnostic value of individual diagnostic tests. RESULTS This meta-analysis pooled 25 eligible studies including 2496 patients with NPC. The sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR) of EBV DNA in the diagnosis of NPC were 0.858 (95% confidence interval (CI): 0.801-0.901), 0.890 (95% CI: 0.866-0.909), 7.782 (95% CI: 6.423-9.429) and 0.159 (95% CI: 0.112-0.226), respectively. The diagnostic odds ratio (DOR) was 48.865 (95% CI: 31.903-74.845). The SROC for EBV DNA detection was 0.93 (95% CI: 0.90-0.95). CONCLUSION The detection of EBV DNA for the diagnosis of recurrent or metastatic NPC has good sensitivity and specificity and might be helpful in monitoring recurrent or metastatic NPC.
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Affiliation(s)
- Haiqin Peng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhanzhan Li
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yujiao Long
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jiahui Li
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhiyuan Liu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Rongrong Zhou
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, China
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12
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Management of locally recurrent nasopharyngeal carcinoma. Cancer Treat Rev 2019; 79:101890. [PMID: 31470314 DOI: 10.1016/j.ctrv.2019.101890] [Citation(s) in RCA: 208] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 12/16/2022]
Abstract
As a consequence of the current excellent loco-regional control rates attained using the generally accepted treatment paradigms involving intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC), only 10-20% of patients will suffer from local and/or nodal recurrence after primary treatment. Early detection of recurrence is important as localized recurrent disease is still potentially salvageable, but this treatment often incurs a high risk of major toxicities. Due to the possibility of radio-resistance of tumors which persist or recur despite adequate prior irradiation and the limited tolerance of adjacent normal tissues to sustain further additional treatment, the management of local failures remains one of the greatest challenges in this disease. Both surgical approaches for radical resection and specialized re-irradiation modalities have been explored. Unfortunately, available data are based on retrospective studies, and the majority of them are based on a small number of patients or relatively short follow-up. In this article, we will review the different salvage treatment options and associated prognostic factors for each of them. We will also propose a treatment algorithm based on the latest available evidence and discuss the future directions of treatment for locally recurrent NPC.
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Liu MZ, Fang SG, Huang W, Wang HY, Tian YM, Huang RD, Sun Z, Zhao C, Lu TX, Huang Y, Han F. Clinical characteristics and prognostic value of pre-retreatment plasma epstein-barr virus DNA in locoregional recurrent nasopharyngeal carcinoma. Cancer Med 2019; 8:4633-4643. [PMID: 31268626 PMCID: PMC6712460 DOI: 10.1002/cam4.2339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/02/2019] [Accepted: 05/22/2019] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To define the clinical characteristics and prognostic value of pre-retreatment plasma Epstein-Barr virus (EBV) DNA, we investigated EBV status in locoregional recurrent nasopharyngeal carcinoma (lrNPC) patients. METHODS Between April 2008 and August 2016, the data of patients with nonmetastatic lrNPC were retrospectively reviewed. The survival indexes of patients between different pre-retreatment EBV status groups were compared. RESULTS A total of 401 patients with nonmetastatic lrNPC were enrolled, and 197 (49.1%) patients had detectable pre-retreatment plasma EBV DNA. Treatment included radiotherapy alone (n = 37 patients), surgery alone (n = 105), radiotherapy (n = 208), surgery combined with radiotherapy (n = 20), chemotherapy and targeted therapy (n = 31). Median follow-up was 32 months. The 3-year locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS) rates for the entire cohort were 64.8%, 89.4%, and 58.8%, respectively. The estimated 3-year LRRFS, DMFS, and OS rates for the pre EBV-positive group vs the pre EBV-negative group were 54.2% vs 75.0% (P < 0.001), 86.6% vs 91.9% (P = 0.05), 51.6% vs 65.9% (P = 0.01), respectively. Among patients in the clinical stage rI/II, there were 17 patients in the radiotherapy alone group and 49 patients in the surgery alone group. And there was no significant difference in overall survival between radiotherapy and surgery, even among the different pre-EBV statuses (P > 0.05). In terms of long-term toxic and side effects, the incidence of radioactive temporal lobe injury in the radiotherapy group was higher than that in the surgery group (35.3% vs 8.2%, P < 0.001), and no statistically significant difference was found in other long-term toxic and side effects. CONCLUSIONS The positive rate of pre-retreatment plasma EBV DNA in lrNPC is lower than primary NPC. The prognosis of EBV DNA negative group is better than positive group. For locally early-stage lrNPC, regardless of EBV DNA status, radiotherapy and surgery are available options and both can achieve better long-term survival.
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Affiliation(s)
- Ming-Zhu Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Shuo-Gui Fang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Wei Huang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Han-Yu Wang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Yun-Ming Tian
- Department of Radiation Oncology, Hui Zhou Municipal Centre Hospital, Huizhou, Guangdong Province, People's Republic of China
| | - Run-Da Huang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Zhuang Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Chong Zhao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Tai-Xiang Lu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Ying Huang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
| | - Fei Han
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, People's Republic of China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong Province, People's Republic of China
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Huang WB, Chan JYW, Liu DL. Human papillomavirus and World Health Organization type III nasopharyngeal carcinoma: Multicenter study from an endemic area in Southern China. Cancer 2017; 124:530-536. [PMID: 29072774 DOI: 10.1002/cncr.31031] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/23/2017] [Accepted: 08/24/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND The current study was conducted to study the incidence of human papillomavirus (HPV)-associated nasopharyngeal carcinoma (NPC) in Southern China and the corresponding treatment outcome. METHODS A retrospective chart review with a level of evidence of 4 was performed. RESULTS Between 2000 and 2015, a total of 1328 patients with NPC were treated in 3 study institutes in Hong Kong and Foshan City in Guangdong Province, China. All tumors were undifferentiated, nonkeratinizing carcinoma, of which 91.9% were positive for the Epstein-Barr virus (EBV+) and 7.7% were positive for HPV/p16 (HPV+). Although coinfection with both viruses occurred only in 8 patients (0.6%), 94 patients had tumors that were EBV negative (EBV-) and HPV+. All patients were treated with intensity-modulated radiotherapy alone for American Joint Committee on Cancer stage I and II disease, and concurrent chemoradiotherapy for stage III and IV disease. With a median follow-up of 72.8 months, the authors found that the local recurrence rate was significantly lower for patients with tumors that were EBV-/HPV+ compared with patients with tumors that were EBV+/HPV- (6.4% vs 13.8%; P = .03). Similar trends were observed for the 5-year disease-free survival rate (89.8% vs 70.8%; P =.03) and 5-year overall survival rate (86% vs 72%; P =.03). CONCLUSIONS In regions that are endemic for NPC, the prevalence of EBV and HPV coinfection in patients with NPC is extremely low. Conversely, patients with EBV-/HPV+ NPC demonstrate significantly better local tumor control and survival after radiotherapy. Cancer 2018;124:530-6. © 2017 American Cancer Society.
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Affiliation(s)
- Wen Bo Huang
- Department of Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Jimmy Yu Wai Chan
- Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary Hospital, Hong Kong
| | - Da Lie Liu
- Department of Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
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15
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Weng J, Wei J, Si J, Qin Y, Li M, Liu F, Si Y, Su J. Clinical outcomes of residual or recurrent nasopharyngeal carcinoma treated with endoscopic nasopharyngectomy plus chemoradiotherapy or with chemoradiotherapy alone: a retrospective study. PeerJ 2017; 5:e3912. [PMID: 29038762 PMCID: PMC5637710 DOI: 10.7717/peerj.3912] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/19/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Local residual and recurrent nasopharyngeal carcinoma (NPC) generally shows treatment failure after standard radiotherapy with or without concurrent chemotherapy. Whether endoscopic nasopharyngectomy might provide an additional therapeutic advantage remains controversial. Therefore, we retrospectively compared the clinical prognoses of patients with residual or recurrent NPC treated with endoscopic nasopharyngectomy combined with chemoradiotherapy (CRT) with those of patients treated with CRT alone. METHODS AND MATERIALS A total of sixty-two patients with local residual or recurrent NPC were studied retrospectively: 36 patients received endoscopic nasopharyngectomy combined with CRT, whereas 26 patients who refused the surgery or had surgical contraindications received CRT alone. Serum Epstein-Barr virus (EBV) DNA levels were measured pre- and post-treatment. The differences in prognosis between the two treatment regimens and the pre- and post-treatment changes in EBV-DNA levels were analyzed. RESULTS The median follow-up time was 31 months, with a 3-year overall survival (OS) of 51.40% and a 3-year disease-free survival (DFS) of 46.86%. The surgery + CRT group had a better OS than the CRT alone group did (χ2 = 4.054, P = 0.044). The pretreatment EBV-DNA levels showed a positive correlation with the clinical staging of recurrent NPC (χ2 = 11.674, P = 0.009). Patients with negative pretreatment serum EBV-DNA levels showed a superior OS to those of patients who tested positive for EBV-DNA (>0 copy/mL) (χ2 = 9.833, P = 0.002). The post-treatment EBV-DNA levels, compared with the pretreatment levels, decreased significantly in the surgery + CRT group (Z = - 3.484, P = 0.000). In contrast, the EBV-DNA levels after CRT alone did not decrease significantly (Z = - 1.956, P = 0.051). Multivariate analysis indicated that local staging, pretreatment EBV-DNA load, and the treatment method were independent risk factors for OS. Subgroup analysis indicated that the patients who tested negative for EBV-DNA before the treatment and those who received surgery + CRT showed a better OS than those who received CRT alone. CONCLUSIONS The pretreatment serum EBV-DNA level was associated with disease prognosis. The combination therapy preceded by surgery can effectively decrease the copy number of EBV-DNA. Patients with local intermediate- and late-stage NPC, especially those negative for EBV-DNA, may consider opting for surgery followed by post-operative adjuvant radiotherapy or chemotherapy.
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Affiliation(s)
- Jingjin Weng
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Department of Otolaryngology & Head and Neck Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jiazhang Wei
- Department of Otolaryngology & Head and Neck Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jinyuan Si
- Department of Otolaryngology & Head and Neck Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yangda Qin
- Department of Otolaryngology & Head and Neck Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Min Li
- Department of Otolaryngology & Head and Neck Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Fei Liu
- Research Center of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yongfeng Si
- Department of Otolaryngology & Head and Neck Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jiping Su
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
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16
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Lao TD, Nguyen DH, Nguyen TM, Le TAH. Molecular Screening for Epstein-Barr virus (EBV): Detection of Genomic EBNA-1, EBNA-2, LMP-1, LMP-2 Among Vietnamese Patients with Nasopharyngeal Brush Samples. Asian Pac J Cancer Prev 2017; 18:1675-1679. [PMID: 28670888 PMCID: PMC6373812 DOI: 10.22034/apjcp.2017.18.6.1675] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Epstein-Bar virus (EBV) is considered to be intimately associated with development of nasopharyngeal carcinoma (NPC), the most common and high incidence cancer of the head and neck in Asian countries, especially in Vietnam. In this study, we validated associations between highly conserved segments of the EBV genome, including EBNA-1, EBNA-2, LMP-1, LMP-2 and nasopharyngeal cancer, with the aim of applications with non-invasive brush samples for early diagnosis and as a prognostic biomarker. The polymerase chain reaction (PCR) was performed to assess the presence of EBNA-1, EBNA-2, LMP-1, LMP-2 in nasopharyngeal brush samples from Vietnamese NPC patients and non-cancer controls. Positive rates for EBNA-1, EBNA-2, LMP-1, LMP-2 were 46.3%, 49.5% and 45.3%, and 47.4%, respectively, in cancer cases, much higher than the low frequencies found in non-cancer samples. Notably, at least one of the four (PI ≥ 0.25) was found in 57. 9%. Significance was reached when computing the odds ratio (OR) and relative risk (RR). Our detection of candidate genes. in nasopharyngeal brush samples collected from Vietnamese patients reduces the need for invasive biopsies and fulfills the characteristics of a non-invasive, specific screening method suitable for routine, NPC risk assessment for EBV-infected populations. Notably, this procedure may be useful for confirmatory screening with large oral brush swabs.
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Affiliation(s)
- Thuan Duc Lao
- Faculty of Biology and Biotechnology, University of Science, Vietnam National University, Vietnam
- Faculty of Biotechnology, Ho Chi Minh City Open University, Ho Chi Minh City, Vietnam.
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17
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Huang WY, Lin CL, Lin CY, Jen YM, Lo CH, Sung FC, Kao CH. Survival outcome of patients with nasopharyngeal carcinoma: a nationwide analysis of 13 407 patients in Taiwan. Clin Otolaryngol 2016; 40:327-34. [PMID: 25581515 DOI: 10.1111/coa.12371] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We reported the contemporary survival outcome of patients with nasopharyngeal carcinoma (NPC) and analysed the factors affecting survival. DESIGN A retrospective cohort study. SETTING A nationwide population-based study in Taiwan. PARTICIPANTS We identified 13 407 patients with newly diagnosed NPC from 2002 to 2010. MATERIAL AND METHODS The multivariate Cox proportional hazards model was performed to measure the mortality-association risk factor in patients with NPC after adjusting for NPC treatment and socio-demographic characteristics. RESULTS The 1-, 2-, 5- and 8-year overall survival (OS) rates were 89.6%, 80.4%, 65.2% and 56.5%, respectively. The factors associated with mortality risk were sex (men versus women, HR = 1.45), age (>60 versus ≤ 40 years, HR = 3.61), geographic region of residence (eastern Taiwan versus northern Taiwan HR = 1.39), income (<15 840 versus >25 000, HR = 1.87) and treatment modality (chemotherapy alone versus radiotherapy alone, HR = 2.25). CONCLUSION The contemporary 5-year OS rate was 65.2% in Taiwan. Male patients, old age, residing in eastern Taiwan, low income and receiving chemotherapy alone were independent predictors for poor OS.
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Affiliation(s)
- W-Y Huang
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - C-L Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - C-Y Lin
- Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou, Chang Gung University, Taoyuan, Taiwan
| | - Y-M Jen
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - C-H Lo
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - F-C Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan
| | - C-H Kao
- Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
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18
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Chan JYW, Wong STS, Chan RCL, Wei WI. Extracranial/intracranial vascular bypass and craniofacial resection: New hope for patients with locally advanced recurrent nasopharyngeal carcinoma. Head Neck 2015; 38 Suppl 1:E1404-12. [PMID: 26566179 DOI: 10.1002/hed.24234] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2015] [Indexed: 01/22/2023] Open
Affiliation(s)
- Jimmy Yu Wai Chan
- Department of Surgery, Division of Head and Neck Surgery; University of Hong Kong Medical Centre Queen Mary Hospital; Hong Kong SAR China
| | - Stanley Thian Sze Wong
- Department of Surgery, Division of Head and Neck Surgery; University of Hong Kong Medical Centre Queen Mary Hospital; Hong Kong SAR China
| | - Richie Chiu Lung Chan
- Department of Surgery, Division of Head and Neck Surgery; University of Hong Kong Medical Centre Queen Mary Hospital; Hong Kong SAR China
| | - William Ignace Wei
- Department of Surgery, Division of Head and Neck Surgery; University of Hong Kong Medical Centre Queen Mary Hospital; Hong Kong SAR China
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19
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Lam JWK, Chan JYW, Ho WK, Tsang RKY. Use of transoral nasopharyngeal brush biopsy for Epstein-Barr virus DNA detection of local recurrence of nasopharyngeal carcinoma after radiotherapy. Head Neck 2015; 38 Suppl 1:E1301-4. [PMID: 26394721 DOI: 10.1002/hed.24216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jacky Wai-Kei Lam
- Division of Otorhinolaryngology - Head and Neck Surgery, Department of Surgery; The University of Hong Kong, Queen Mary Hospital; Hong Kong China
| | - Jimmy Yu-Wai Chan
- Division of Otorhinolaryngology - Head and Neck Surgery, Department of Surgery; The University of Hong Kong, Queen Mary Hospital; Hong Kong China
| | - Wai-Kuen Ho
- Division of Otorhinolaryngology - Head and Neck Surgery, Department of Surgery; The University of Hong Kong, Queen Mary Hospital; Hong Kong China
| | - Raymond King-Yin Tsang
- Division of Otorhinolaryngology - Head and Neck Surgery, Department of Surgery; The University of Hong Kong, Queen Mary Hospital; Hong Kong China
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20
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Tsai MC, Shu YC, Hsu CC, Lin CK, Lee JC, Chu YH, Huang WY. False-positive finding of retropharyngeal lymph node recurrence in both fluorine (18)FDG PET and MRI in a patient with nasopharyngeal carcinoma. Head Neck 2015; 38:E84-6. [PMID: 26315947 DOI: 10.1002/hed.24205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 06/10/2015] [Accepted: 07/08/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Biopsy of the retropharyngeal node is not routinely accessible. The diagnosis of retropharyngeal lymph node recurrence in patients with nasopharyngeal carcinoma (NPC) is often based on an imaging study. METHODS We reported a patient with NPC who was incorrectly diagnosed with left retropharyngeal lymph node recurrence by both MRI and positron emission tomography (PET)/CT. RESULTS A woman who was treated for stage IVA NPC 2 years previously was found to have a nodal lesion in the left retropharyngeal space on MRI together with focal fluorodeoxyglucose (FDG) uptake on PET/CT. Locoregional recurrence was suspected, and surgery was performed. Subsequent pathology results showed reactive lymphoid hyperplasia. CONCLUSION Although tissue biopsy for the retropharyngeal node is technically difficult, this case demonstrates that tumor recurrence cannot be diagnosed even based on both positive findings on MRI and PET/CT in patients with NPC.
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Affiliation(s)
- Ming-Chen Tsai
- Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chi Shu
- Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Chen Hsu
- Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Kung Lin
- Department of Pathology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.,Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jih-Chin Lee
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yueng-Hsiang Chu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Yen Huang
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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21
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Zhao FP, Liu X, Chen XM, Lu J, Yu BL, Tian WD, Wang LU, Xu X, Huang HR, Zhang MW, Li G, Li XP. Levels of plasma Epstein-Barr virus DNA prior and subsequent to treatment predicts the prognosis of nasopharyngeal carcinoma. Oncol Lett 2015; 10:2888-2894. [PMID: 26722258 DOI: 10.3892/ol.2015.3628] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 03/26/2015] [Indexed: 01/01/2023] Open
Abstract
The level of Epstein-Barr virus DNA (EBV-DNA) in the plasma prior and subsequent to treatment is a reliable biomarker for the screening, diagnosis, monitoring and prognosis of nasopharyngeal carcinoma (NPC). The present retrospective study aimed to determine whether pre- and post-treatment levels of plasma EBV-DNA were predictive of survival in a large sample of patients with NPC. The level of plasma EBV-DNA in 637 NPC patients prior and subsequent to treatment was determined by quantitative polymerase chain reaction. The value of pre- and post-treatment plasma EBV-DNA in predicting the survival of NPC patients was then analyzed. The results revealed that pre-treatment plasma EBV-DNA loads were significantly higher in patients with NPC than those in healthy controls (P<0.001). The percentage of patients with positive plasma EBV-DNA was markedly higher prior to treatment (70.64%; median, 1150 copies/ml; range, 0-9.75×106 copies/ml) than following treatment (25.99%; median, 0 copies/ml; range, 0-3.83×106 copies/ml) (P<0.001). Patients with a high plasma EBV-DNA load presented with a higher clinical tumor classification, lymph node status, metastatic status and overall cancer stage. The risk of NPC relapse and mortality was higher in patients with pre-treatment plasma EBV-DNA levels of ≥1,500 copies/ml than that in patients with <1,500 copies/ml. Furthermore, the risk of relapse and mortality was higher in patients with positive post-treatment plasma EBV-DNA than in patients with negative post-treatment plasma EBV-DNA. Detectable post-treatment plasma EBV-DNA was the most significant prognostic factor to affect relapse-free survival, whilst metastasis was the prognostic factor with the greatest effect on overall survival. These data indicated that pre- and post-treatment levels of plasma EBV-DNA were able to predict the prognosis of NPC. This finding may provide novel references for research and clinical practice.
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Affiliation(s)
- Fei-Peng Zhao
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China ; Department of Otolaryngology - Head and Neck Surgery, The Affiliated Hospital of Luzhou Medical College, Luzhou Medical College, Luzhou, Sichuan, 646000, P.R. China
| | - Xiong Liu
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Xiao-Mei Chen
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Juan Lu
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Bo-Long Yu
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Wen-Dong Tian
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - L U Wang
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Xia Xu
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Hao-Ran Huang
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Meng-Wen Zhang
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Gang Li
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Xiang-Ping Li
- Department of Otolaryngology - Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
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Kan R, Shuen WH, Lung HL, Cheung AKL, Dai W, Kwong DLW, Ng WT, Lee AWM, Yau CC, Ngan RKC, Tung SY, Lung ML. NF-κB p65 Subunit Is Modulated by Latent Transforming Growth Factor-β Binding Protein 2 (LTBP2) in Nasopharyngeal Carcinoma HONE1 and HK1 Cells. PLoS One 2015; 10:e0127239. [PMID: 25974126 PMCID: PMC4431814 DOI: 10.1371/journal.pone.0127239] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/12/2015] [Indexed: 01/22/2023] Open
Abstract
NF-κB is a well-characterized transcription factor, widely known as a key player in tumor-derived inflammation and cancer development. Herein, we present the functional and molecular relevance of the canonical NF-κB p65 subunit in nasopharyngeal carcinoma (NPC). Loss- and gain-of-function approaches were utilized to reveal the functional characteristics of p65 in propagating tumor growth, tumor-associated angiogenesis, and epithelial-to-mesenchymal transition in NPC cells. Extracellular inflammatory stimuli are critical factors that trigger the NF-κB p65 signaling; hence, we investigated the components of the tumor microenvironment that might potentially influence the p65 signaling pathway. This led to the identification of an extracellular matrix (ECM) protein that was previously reported as a candidate tumor suppressor in NPC. Our studies on the Latent Transforming Growth Factor-β Binding Protein 2 (LTBP2) protein provides substantial evidence that it can modulate the p65 transcriptional activity. Re-expression of LTBP2 elicits tumor suppressive effects that parallel the inactivation of p65 in NPC cells. LTBP2 was able to reduce phosphorylation of p65 at Serine 536, inhibit nuclear localization of active phosphorylated p65, and impair the p65 DNA-binding ability. This results in a consequential down-regulation of p65-related gene expression. Therefore, the data suggest that the overall up-regulation of p65 expression and the loss of this candidate ECM tumor suppressor are milestone events contributing to NPC development.
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Affiliation(s)
- Rebecca Kan
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
| | - Wai Ho Shuen
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
| | - Hong Lok Lung
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Center for Cancer Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
| | - Arthur Kwok Leung Cheung
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Center for Cancer Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
| | - Wei Dai
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
| | - Dora Lai-Wan Kwong
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Center for Cancer Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Center for Nasopharyngeal Carcinoma Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
| | - Wai Tong Ng
- Center for Nasopharyngeal Carcinoma Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (SAR), PR China
| | - Anne Wing Mui Lee
- Center for Nasopharyngeal Carcinoma Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Department of Clinical Oncology, The University of Hong Kong—Shen Zhen Hospital, PR China
| | - Chun Chung Yau
- Center for Nasopharyngeal Carcinoma Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Department of Oncology, Princess Margaret Hospital, Hong Kong (SAR), PR China
| | - Roger Kai Cheong Ngan
- Center for Nasopharyngeal Carcinoma Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong (SAR), PR China
| | - Stewart Yuk Tung
- Center for Nasopharyngeal Carcinoma Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong (SAR), PR China
| | - Maria Li Lung
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Center for Cancer Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- Center for Nasopharyngeal Carcinoma Research, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (SAR), PR China
- * E-mail:
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Chan JYW, Wong STS, Wei WI. The role of Epstein-Barr virus-encoded microRNA BART7 status of resection margins in the prediction of local recurrence after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma. Cancer 2015; 121:2358-66. [PMID: 25955785 DOI: 10.1002/cncr.29380] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 02/03/2015] [Accepted: 02/09/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Local recurrence is the major cause of treatment failure in patients who undergo surgical salvage of recurrent nasopharyngeal carcinoma (NPC) after radiotherapy. The authors investigated the role of Epstein-Barr virus (EBV)-encoded Bam HI-A rightward transcript 7 microRNA (BART7) status in resection margins in the identification of a subgroup of patients who may benefit from adjuvant reradiation after surgery. METHODS One hundred two consecutive patients who had histologically clear resection margins after undergoing nasopharyngectomy for recurrent NPC were studied. The status of EBV microRNA BART7 in resection margins was investigated and correlated with the pattern of subsequent disease recurrence. RESULTS After a median follow-up of 64 months, 20 patients (19.6%) developed local recurrence after surgery despite histologically uninvolved margins. The risk of local recurrence in patients with histologically close (<5 mm) and clear (≥5 mm) margins was 31.6% and 12.5%, respectively. In patients with clear histologic margins, those with margins that were positive for EBV microRNA BART7 has a significantly higher chance of developing local tumor recurrence (P = .016) than those with negative molecular margins. The difference was not significant when the histologic clearance at the resection margins was <5 mm. CONCLUSIONS Tissue EBV microRNA BART7 is useful for identifying a subgroup of patients with histologically clear margins who are at increased risk of subsequent local tumor recurrence. Postoperative adjuvant treatment is warranted for these patients.
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Affiliation(s)
- Jimmy Yu Wai Chan
- Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary Hospital, Hon Kong SAR, China
| | - Stanley Thian Sze Wong
- Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary Hospital, Hon Kong SAR, China
| | - William Ignace Wei
- Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary Hospital, Hon Kong SAR, China
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Shen T, Tang LQ, Luo DH, Chen QY, Li PJ, Mai DM, Guo SS, Liu LT, Qian CN, Guo X, Zeng MS, Mo HY, Mai HQ. Different prognostic values of plasma Epstein-Barr virus DNA and maximal standardized uptake value of 18F-FDG PET/CT for nasopharyngeal carcinoma patients with recurrence. PLoS One 2015; 10:e0122756. [PMID: 25853677 PMCID: PMC4390333 DOI: 10.1371/journal.pone.0122756] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/12/2015] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To evaluate and compare the prognostic value of Epstein-Barr virus (EBV) DNA and maximal standard uptake values (SUVmax ) of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) in subgroups of nasopharyngeal carcinoma (NPC) patients with locoregional or distant recurrence. PATIENTS AND METHODS A total of 194 patients with recurrent NPC (locoregional recurrence: 107, distant recurrence: 87) were enrolled. Patients took evidence of recurrence performed with 18F-FDG-PET and an EBV DNA test before salvage treatment. Clinical parameters, the status of EBV DNA and the value of SUVmax were used for survival analysis using the Kaplan-Meier method and the Cox proportional hazards regression model. RESULTS In the subgroup of patients with locoregional recurrence, patients with SUVmax<8.65 had significantly better overall survival (OS) (P=0.005) compared with the patients with SUVmax ≥8.65. However, both elevated EBV DNA load (≥21,100 copies/ml) and distant SUVmax (≥13.55) were significantly associated with worse OS compared with the patients with EBV DNA <21,100 copies/ml or distant SUVmax <13.55 for the subgroup with distant recurrence (P=0.015 and P=0.006, respectively). The predictive ability of EBV DNA was superior to that of SUVmax (P=0.062). Multivariate analysis showed that SUVmax was only an independent prognostic factor for OS in patients with locoregional recurrence (P=0.042), whereas EBV DNA independently predicted OS for the patients with distant recurrence (P=0.007). For those patients with undetectable EBV DNA, SUVmax<8.65 was still an independent favorable prognostic factor (P=0.038). CONCLUSIONS SUVmax is a useful biomarker for predicting OS in nasopharyngeal carcinoma patients with locoregional recurrence or with undetectable EBV DNA. Both distant SUVmax and EBV DNA appear to be independent predictors of OS in patients with distant recurrence; however, the predictive ability of EBV DNA was superior to that of SUVmax.
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Affiliation(s)
- Ting Shen
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Lin-Quan Tang
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Dong-Hua Luo
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Qiu-Yan Chen
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Pei-Jing Li
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Dong-Mei Mai
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Shan-Shan Guo
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Li-Ting Liu
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Chao-Nan Qian
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Xiang Guo
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Mu-Sheng Zeng
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Hao-Yuan Mo
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- * E-mail: (HQM); (HYM)
| | - Hai-Qiang Mai
- The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- * E-mail: (HQM); (HYM)
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Kanakry J, Ambinder R. The Biology and Clinical Utility of EBV Monitoring in Blood. Curr Top Microbiol Immunol 2015; 391:475-99. [PMID: 26428386 DOI: 10.1007/978-3-319-22834-1_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Epstein-Barr virus (EBV) DNA in blood can be quantified in peripheral blood mononuclear cells, in circulating cell-free (CCF) DNA specimens, or in whole blood. CCF viral DNA may be actively released or extruded from viable cells, packaged in virions or passively shed from cells during apoptosis or necrosis. In infectious mononucleosis, viral DNA is detected in each of these kinds of specimens, although it is only transiently detected in CCF specimens. In nasopharyngeal carcinoma, CCF EBV DNA is an established tumor marker. In EBV-associated Hodgkin lymphoma and in EBV-associated extranodal NK-/T-cell lymphoma, there is growing evidence for the utility of CCF DNA as a tumor marker.
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Affiliation(s)
- Jennifer Kanakry
- Department of Oncology, Johns Hopkins School of Medicine, 389 CRB1 1650 Orleans, Baltimore, MD, 21287, USA
| | - Richard Ambinder
- Department of Oncology, Johns Hopkins School of Medicine, 389 CRB1 1650 Orleans, Baltimore, MD, 21287, USA.
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26
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Zhao FP, Liu X, Zhong ZM, Lu J, Yu BL, Zeng FY, Chen XM, Chen HH, Peng XH, Wang F, Peng Y, Li XP. Positivity of both plasma Epstein-Barr virus DNA and serum Epstein-Barr virus capsid specific immunoglobulin A is a better prognostic biomarker for nasopharyngeal carcinoma. BBA CLINICAL 2014; 2:88-93. [PMID: 26673151 PMCID: PMC4655226 DOI: 10.1016/j.bbacli.2014.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 10/19/2014] [Accepted: 10/23/2014] [Indexed: 11/29/2022]
Abstract
Background Positivity of plasma Epstein–Barr virus (EBV)-DNA or serum virus capsid antigen-specific IgA (VCA-IgA) is a biomarker for the prognosis of nasopharyngeal carcinoma (NPC). The objective of this study was to determine the value of positivity for plasma EBV-DNA and/or VCA-IgA in predicting the survival of patients with NPC. Methods Plasma EBV-DNA and serum VCA-IgA in 506 NPC patients in this retrospective study were detected by quantitative real time polymerase chain reaction and enzyme-linked immunoabsorbent assay, respectively. The value of positivity for EBV-DNA and/or VCA-IgA in predicting the survival of patients with NPC was analyzed. Results Patients with positivity for both EBV-DNA and VCA-IgA had significantly shorter periods of relapse free survival (RFS) and overall survival (OS) than those with positive single measure or negative for both measures, and patients with positive single measure had significantly shorter periods of RFS and OS than those with negative for both. Multivariate analysis indicated that the positivity for EBV-DNA and/or VCA-IgA were significant risk factors for shorter periods of RFS and OS. Conclusion These data indicated that positivity for both EBV-DNA and VCA-IgA was a better biomarker for the prognosis of patients with NPC. Our findings may provide new references for clinical practice. We analyzed the positivity for EBV-DNA and/or VCA-IgA in predicting NPC survival. Patients with both EBV-DNA(+) and VCA-IgA(+) had significantly shorter RFS and OS. EBV-DNA and/or VCA-IgA were significant risk factors for NPC survival.
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Affiliation(s)
- Fei-Peng Zhao
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; Department of Otolaryngology, the Third People's Hospital of Chengdu, Chengdu 610031, China
| | - Xiong Liu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Zhi-Ming Zhong
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Juan Lu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Bo-Long Yu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Fang-Yin Zeng
- Department of Laboratory, the Fifth Affiliated Hospital of Southern Medical University, Southern Medical University, Guangzhou 510900, China
| | - Xiao-Mei Chen
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Huai-Hong Chen
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xiao-Hong Peng
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Fan Wang
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Ying Peng
- Department of Neurology, the Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Xiang-Ping Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Radiosensitization effect of nedaplatin on nasopharyngeal carcinoma cells in different status of Epstein-Barr virus infection. BIOMED RESEARCH INTERNATIONAL 2014; 2014:713674. [PMID: 24900979 PMCID: PMC4036599 DOI: 10.1155/2014/713674] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/15/2014] [Indexed: 12/17/2022]
Abstract
This study aims to evaluate the radiosensitization effect of nedaplatin on nasopharyngeal carcinoma (NPC) cell lines with different Epstein-Barr virus (EBV) status. Human NPC cell lines CNE-2 (EBV-negative) and C666 (EBV-positive) were treated with 0-100 μg/mL nedaplatin, and inhibitory effects on cell viability and IC50 were calculated by MTS assay. We assessed changes in radiosensitivity of cells by MTS and colony formation assays, and detected the apoptosis index and changes in cell cycle by flow cytometry. MTS assay showed that nedaplatin caused significant cytotoxicity in CNE-2 and C666 cells in a time- and dose-dependent manner. After 24 h, nedaplatin inhibited growth of CNE-2 and C666 cells with IC50 values of 34.32 and 63.69 μg/mL, respectively. Compared with radiation alone, nedaplatin enhanced the radiation effect on both cell lines. Nedaplatin markedly increased apoptosis and cell cycle arrest in G2/M phase. Nedaplatin radiosensitized human NPC cells CNE-2 and C666, with a significantly greater effect on the former. The mechanisms of radiosensitization include induction of apoptosis and enhancement of cell cycle arrest in G2/M phase.
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