ABSTRACT
<p><b>OBJECTIVE</b>This study was aimed to investigate the association between serum against Epstein-Barr virus (EBV) antibodies levels and nasopharyngeal carcinoma (NPC) patients' prognosis.</p><p><b>METHODS</b>Blood samples from 140 primary NPC patients without metastasis were collected before and after treatment. The titers of VCA/IgA and EA/IgA were detected by immunoenzyme assay, and the levels of NA1/IgA and Rta/IgG were detected by enzyme-linked immunosorbent assay (ELISA). All patients received consequent follow-up and long-term efficacy and survival assessment.</p><p><b>RESULTS</b>Post-treatment serum levels of VCA/IgA, EA/IgA, NA1/IgA and Rta/IgG in NPC patients significantly decreased than those before treatment, while had significantly higher than those in control individuals (P < 0.05). Patients in remission had significantly lower pre-treatment serum levels of VCA/IgA and EA/IgA than patients with progression (P < 0.05). None of serum levels of VCA/IgA, EA/IgA, NA1/IgA and Rta/IgG was associated with the 3-year overall survival (P > 0.05). The progression-free survivals were significantly lower in patients with higher pre-treatment VCA/IgA (> or = 1 : 320) and EA/IgA (> or = 1:80) levels than in those with lower VCA/IgA ( < 1 : 320) and EA/IgA (< 1 : 80) levels, respectively (61.8% vs. 86.5% , 61.3% vs. 86.5%, P < 0.001). Cox regression model analysis demonstrated that pre-treatment serum VCA/IgA level was an independent risk factor for progression-free survival (HR = 3.80, P = 0.001).</p><p><b>CONCLUSION</b>Anti-EBV VCA/IgA and EA/IgA might provide information regarding the prognosis of NPC patients.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Antibodies, Viral , Blood , Antigens, Viral , Allergy and Immunology , Capsid Proteins , Allergy and Immunology , Carcinoma , Herpesvirus 4, Human , Allergy and Immunology , Immunoglobulin A , Blood , Nasopharyngeal Neoplasms , Mortality , Virology , PrognosisABSTRACT
<p><b>OBJECTIVE</b>To evaluate the relationship between the clinical stages of nasopharyngeal carcinoma (NPC) and Epstein-Barr virus (EBV) antibodies Rta/IgG, EBNA1/IgA, VCA/IgA and EA/IgA.</p><p><b>METHODS</b>Serum samples obtained from 211 untreated patients with NPC categorized by the project of 92' stage were examined for the presence of the EBV antibodies Rta/IgG and EBNA1/IgA by enzyme-linked immnunosorbent assay (ELISA) and for VCA/IgA and EA/IgA by immunoenzymatic assay. The positive rates and antibody levels in the NPC patients in different TNM stages and clinical stages were analyzed statistically.</p><p><b>RESULTS</b>No significant difference in Rta/IgG rA value was found in the NPC patients in different TNM or clinical stages (P>0.05). The EBNA1/IgA rA value was significantly lower in stage T1, N0, and clinical stage I than in the other corresponding T stages, N stages and other clinical stage (P<0.05). The antibody titers of VCA/IgA and EA/IgA differed significantly between the N stages and the clinical stages (P<0.05).</p><p><b>CONCLUSION</b>The expression of EBV Rta/IgG is not associated with NPC stage. The expression of EBNA1/IgA is relatively low in early NPC. The antibody level of VCA/IgA and EA/IgA are significantly correlated to the degree of neck lymph node metastasis, and might be helpful to classify the clinical stages of NPC.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Viral , Blood , Allergy and Immunology , Antigens, Viral , Allergy and Immunology , Capsid Proteins , Allergy and Immunology , Epstein-Barr Virus Nuclear Antigens , Allergy and Immunology , Herpesvirus 4, Human , Allergy and Immunology , Immediate-Early Proteins , Allergy and Immunology , Immunoglobulin A , Blood , Immunoglobulin G , Blood , Nasopharyngeal Neoplasms , Allergy and Immunology , Pathology , Virology , Neoplasm Staging , Trans-Activators , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the value of combined detection of Epstein-Barr virus (EBV) VCA/IgA, EA/IgA, Rta/IgG and EBNA1/IgA in serodiagnosis of nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>Serum samples obtained from 211 untreated patients with NPC and 203 non-NPC ENT patients were examined for the presence of VCA/IgA and EA/IgA by immunoenzymatic assay and for Rta/IgG and EBNA1/IgA by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was generated to confirm the cutoff values of different antibodies. The evaluation indexes of combined detection of multiple antibodies used for serodiagnosis of NPC were calculated with compounded positive judgment method.</p><p><b>RESULTS</b>Compared to a single antibody, combined detection achieved a higher sensitivity and specificity. The sensitivity of VCA/IgA + Rta/IgG + EBNA1/IgA (98.1%) was higher than the other 3 combinations with a specificity, accuracy, Youden index and positive predictive value (PPV) of 88.7%, 93.5%, 0.868 and 90.0%, respectively. The combination of EA/IgA+Rta/IgG+EBNA1/IgA had the highest specificity (95.1%), accuracy (94.9%), Youden index (0.899) and PPV (95.2%), with a sensitivity of 94.8%, suggesting its higher accuracy in the serodiagnosis of NPC. Combined detection of the 4 antibodies had the highest sensitivity (98.6%) with a specificity, accuracy, Youden index and PPV of 88.2%, 93.5%, 0.868 and 89.7%, respectively.</p><p><b>CONCLUSIONS</b>Combined detection of Rta/IgG against immediate early antigens, EA/IgA against early antigens, VCA/IgA against late antigens, and EBNA1/IgA against latent antigens provides better understanding of the expression profiles of EBV lytic and latent antigens with excellent complementarity, and may serve as an optimal combination for NPC serodiagnosis.</p>