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Serologic biomarkers of Epstein–Barr virus correlate with TNM classification according to the seventh edition of the UICC/AJCC staging system for nasopharyngeal carcinoma

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Abstract

This study aimed to investigate the association between Epstein–Barr virus (EBV)-related biomarkers and TNM classification according to the seventh edition of AJCC/UICC staging system for nasopharyngeal carcinoma. Serum VCA-IgA and EA-IgA titers and plasma EBV-DNA load were quantified at baseline in 779 patients; the rates of positivity and titers/load were compared by TNM classification. The VCA-IgA-positive rate was significantly associated with advanced N classification and stage; the EA-IgA-positive rate with advanced T and N classifications and stage; the EBV-DNA-positive rate with advanced T, N and M classifications and stage. The percentage of triple-positive patients was higher in patients with advanced TNM classification. The VCA-IgA titer and EA-IgA titer correlated positively with T classification, N classification and disease stage (1:117 in Stage I, 1:188.4 in Stage II, 1:231.12 in Stage III, 1:265.91 in Stage IV, and 1:18.34 in Stage I, 1:32.11 in Stage II, 1:34.77 in Stage III, 1:37.65 in Stage IV, respectively). EBV DNA load correlated positively with T, N and M classification and stage [median lg (EBV DNA): 0 (IQ range 0–1.85) in Stage I, 1.32 (0–3.51) in Stage II, 3.33 (0–4.30) in Stage III, 3.83 (2.85–4.71) in Stage IV]. Serum VCA-IgA/EA-IgA titers and plasma EBV DNA correlated strongly with TNM classification according to the seventh edition of the AJCC/UICC; however, plasma EBV DNA load could accurately predict metastatic disease. EBV serological biomarkers may enhance the accuracy of TNM staging and help to avoid excessive imaging examinations in routine evaluation.

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Acknowledgments

This study was supported by grants from the General Funds of the National Natural Science Foundation of China (No. 81272575) and the Science and Technology Planning Project of Guangdong Province, China (Nos. 2010B080701015 and 2012A030400038).

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Authors and Affiliations

  1. Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People’s Republic of China

    Peng Sun, Yi-Kan Cheng, Li-Zhi Liu & Mo-Fa Gu

  2. Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, 651st Dongfeng Road East, Guangzhou, 510060, Guangdong, People’s Republic of China

    Peng Sun

  3. Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, People’s Republic of China

    Cui Chen

  4. Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, 651st Dongfeng Road East, Guangzhou, 510060, Guangdong, People’s Republic of China

    Yi-Kan Cheng & Mo-Fa Gu

  5. Department of Oncology, The First People’s Hospital of Zhaoqing City, Zhaoqing, 526021, Guangdong, People’s Republic of China

    Zhi-Jian Zeng

  6. Department of Preventive Medicine and Biostatistics, Basic Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong, People’s Republic of China

    Xin-Lin Chen

  7. Imaging Diagnosis and Interventional Center, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, Guangdong, People’s Republic of China

    Li-Zhi Liu

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  1. Peng Sun
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  2. Cui Chen
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  3. Yi-Kan Cheng
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  4. Zhi-Jian Zeng
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  7. Mo-Fa Gu
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Correspondence to Peng Sun or Mo-Fa Gu.

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P. Sun and C. Chen contributed equally to this work.

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Sun, P., Chen, C., Cheng, YK. et al. Serologic biomarkers of Epstein–Barr virus correlate with TNM classification according to the seventh edition of the UICC/AJCC staging system for nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol 271, 2545–2554 (2014). https://doi.org/10.1007/s00405-013-2805-5

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