Abstract:
Objective The present study explores the significance of Epstein-Barr virus DNA (EBV-DNA) in the diagnosis and monitoring of the clinical responses of patients with metastatic nasopharyngeal carcinoma (NPC).
Methods Plasma was collected from 16 metastatic NPC patients admitted to the Cancer Hospital of Zhongshan University between December 2006 and June 2007. All patients underwent six cycles of chemotherapy with the regimen of cisplatin plus 5-Fu and individual taxol/carboplatin. Peripheral blood was collected at every other two cycles of chemotherapy, and the response was assessed using radiological examination. A real-time quantitative polymerase chain reaction system was used to determine the Epstein-Barr virus DNA in the plasma.
Results After the chemotherapy, as the EBV-DNA concentration decreased, the variation in the level of plasma EBV-DNA reflected the tumor response, with a concordance rate over 80%. When the EBV-DNA concentration increased, the variation in the level of plasma EBV-DNA reflected the actual tumor response, with a concordance rate of 100%. When the EBV-DNA concentration was always 0, the tumor response was not reflected. After comparing the relationship between the short effect and the change in the log EBV-DNA before and after chemotherapy, the means of the changes in the log EBV-DNA were -4.63, -2.25, and 3.23 in patients achieving partial remission, stable disease, and progression of disease, respectively. A statistical significance was obtained when the three groups were compared (P=0.025).
Conclusion Plasma EBV-DNA could be a sero-diagnostic index in assessing the curative effect of metastatic NPC. Combined application of serology with radiography could improve the accuracy of the assessment.
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