Evaluation of plasma Epstein-Barr virus DNA as a biomarker for Epstein-Barr virus-associated Hodgkin lymphoma.

ABSTRACT

OBJECTIVES: Epstein-Barr virus is a tumorigenic virus and has been extensively studied as a causative agent for Hodgkin lymphoma. Although immunostaining of the tumor biopsy is the standard method for diagnosis of Epstein-Barr virus-driven Hodgkin lymphoma, the invasiveness of the procedure renders it difficult and less desirable for the patients. Therefore, we designed this study to evaluate the efficiency of plasma Epstein-Barr virus DNA detection as an alternative diagnostic and prognostic method for Epstein-Barr virus-associated Hodgkin lymphoma. METHODS: This analytical cross-sectional study was conducted during March 2017 to December 2018 including 43 Hodgkin lymphoma patients diagnosed histopathologically followed by the latent membrane protein-1 immunohistochemistry to determine their Epstein-Barr virus association. Plasma Epstein-Barr virus DNA in these samples was measured using quantitative polymerase chain reaction (qPCR). RESULTS: Of total, 29 (67.44%) patients tested positive for plasma Epstein-Barr virus DNA. On comparing results of latent membrane protein-1 immunohistochemistry (IHC) with plasma Epstein-Barr virus DNA, plasma Epstein-Barr virus DNA was found in 25 of 30 patients with latent membrane protein-1 expression and 4 of 13 patients without latent membrane protein-1 expression. The sensitivity and the specificity of plasma Epstein-Barr virus DNA detection with respect to latent membrane protein-1 IHC were found to be 83.33% and 69.23%, respectively (p = 0.0014). CONCLUSION: Determination of plasma Epstein-Barr virus DNA was found to be highly sensitive and specific in characterizing Epstein-Barr virus-associated Hodgkin lymphoma, suggesting that this diagnostic method holds promise as an alternative and more convenient method of diagnosis compared with tissue biopsy.