RESUMO
Nasopharyngeal cancer (NPC) is associated with Epstein Barr virus (EBV) infection. However different viral strains have been implicated in NPC worldwide. This study aimed to detect and characterize EBV in patients diagnosed with NPC in Ghana. A total of 55 patients diagnosed with NPC by CT scan and endoscopy were age-matched with 53 controls without a known oncological disease. Venous blood was collected from the study participants and DNA extracted from the blood samples. Detection of EBV and genotyping were done by amplifying Epstein Barr nuclear antigen 1 (EBNA-1) and Epstein Barr nuclear antigen 2 (EBNA-2), respectively, using specific primers. Viral load in patients and controls was determined using real-time polymerase chain reaction. EBV positivity in controls (92%) was significantly greater than that of NPC patients (67%) (χ2 = 19.17, p < 0.0001), and viral infection was independent of gender (χ2 = 1.770, p = 0.1834). The predominant EBV genotypes in patients and controls were genotype 2 (52%) and genotype 1 (62%), respectively. Median EBV load was significantly higher in NPC patients than the control group (p < 0.01). In summary, prevalence of EBV genotype 2 infection was higher in NPC patients than the control group. Assessment of EBV load may be used as a biomarker for the diagnosis of NPC.
Assuntos
Infecções por Vírus Epstein-Barr/complicações , Herpesvirus Humano 4/genética , Carcinoma Nasofaríngeo/virologia , Neoplasias Nasofaríngeas/virologia , Adulto , Estudos de Casos e Controles , DNA Viral/genética , Infecções por Vírus Epstein-Barr/virologia , Antígenos Nucleares do Vírus Epstein-Barr/genética , Feminino , Técnicas de Genotipagem , Gana , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/etiologia , Neoplasias Nasofaríngeas/etiologia , Reação em Cadeia da Polimerase , Reação em Cadeia da Polimerase em Tempo Real , Carga Viral , Proteínas Virais/genéticaRESUMO
IMPACT STATEMENT: Region-specific cancer reports are essential in knowing the common cancers in specific populations. This study reports all cancer types recorded in the major hospitals in the Volta Region of Ghana, a population that is sparsely captured in the national cancer registries. The study identified the common cancers as well as the death rates in the Volta Region, hence contributing to the national effort to report cancer data. Although not comprising all the elements of a cancer registry, our data will augment the effort of the two national cancer registries in Ghana to provide the national cancer reports.
Assuntos
Neoplasias/epidemiologia , Neoplasias/mortalidade , Feminino , Gana/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-IdadeRESUMO
Epstein Barr virus (EBV) is a cosmopolitan oncogenic virus, infecting about 90% of the world's population and it is associated to tumors originating from both epithelia and hematopoietic cells. Transmission of the virus is mainly through oral secretions; however, transmission through organ transplantation and blood transfusion has been reported. In order to evade immune recognition, EBV establishes latent infection in B lymphocytes where it expresses limited sets of proteins called EBV transcription programs (ETPs), including six nuclear antigens (EBNAs), three latent membrane proteins (LMP), and untranslated RNA called EBV encoded RNA (EBER), shown to efficiently transform B cells into lymphoblastic cells. These programs undergo different patterns of expression which determine the occurrence of distinct types of latency in the pathogenesis of a particular tumor. Hematopoietic cell derived tumors include but not limited to Burkitt's lymphoma, Hodgkin lymphoma, post-transplant lymphoproliferative disorders, and natural killer (NK)/T cell lymphoma. EBV undergoes lytic infection in epithelia cells for amplification of the viral particle for transmission where it expresses lytic stage genes. However, for reasons yet to be unveiled, EBV switches from the expression of lytic stage genes to the expression of ETPs in epithelia cells. The expression of the ETPs lead to the transformation of epithelia cells into permanently proliferating cells, resulting in epithelia cell derived malignancies such as nasopharyngeal cancer, gastric cancer, and breast cancer. In this review, we have summarized the current updates on EBV associated epithelial and B cell-derived malignancies, and the role of EBV latency gene products in the pathogenesis of the cancers, and have suggested areas for future studies when considering therapeutic measures.
RESUMO
Background. The aim of this study was to identify the frequently diagnosed pediatric diseases in the Volta Region of Ghana, as well as to examine the burden of these diseases. The top pediatric diseases that were frequently diagnosed were malaria, gastroenteritis, systemic infection, anemia, pneumonia, and respiratory tract infection. Methods. Clearance was obtained from the Volta Regional Directorate of the Ghana Health Service to collect primary data on pediatric hospitalizations in the major hospitals in the Region. Diseases with more than 1000 recorded cases of hospitalizations were considered among the top frequently diagnosed childhood morbidities. Results. The data suggest that the Northern sector had different seasonal patterns of recorded diagnosed pediatric cases compared with the Central and Southern sectors, which had similar patterns of the reported diseases. Most of the pediatric diseases in the Volta Region were more prevalent during the dry seasons compared with the rainy seasons and resulting in seasonal patterns of hospitalizations. Conclusion. Although the frequently diagnosed pediatric diseases can be prevented and/or treated, many children are hospitalized, with a proportion of them dying. It is, therefore, important that efforts are made to reduce the burden of pediatric hospitalization.