Abstract
BackgroundTo investigate the predictive value of chemokine CCL27 for identifying early stage nasopharyngeal carcinoma (NPC) patients within a population seropositive for Epstein-Barr virus (EBV) capsid antigen-specific IgA (VCA-IgA).MethodsCCL27 in plasma samples from 104 NPC patients, 112 VCA-IgA–positive healthy donors, and 140 VCA-IgA–negative normal subjects was measured by ELISA. Expression of CCL27 in nasopharyngeal tissue from 20 VCA-IgA–positive healthy donors and 20 NPC patients was examined by immunohistochemical staining.ResultsLevels of CCL27 in the plasma of VCA-IgA–positive healthy donors (607.33 ± 218.81 pg/ml) were significantly higher than the levels in all NPC patients (437.09 ± 217.74, P = < 0.0001) and in the subset of patients with early stage NPC (463.85 ± 226.17, P = 0.0126). Plasma CCL27 levels were significantly lower in the VCA-IgA–negative normal subjects (358.22 ± 133.15 pg/ml) than in either the VCA-IgA–positive healthy donors (P < 0.0001) or the NPC patients (P = 0.0113). CCL27 protein was detected in 16 of 20 (80%) nasopharyngeal tissue samples from VCA-IgA–positive healthy donors and in 3 of 20 (15%) tumor tissue samples from NPC patients. There was no relationship between CCL27 levels and VCA-IgA titers or plasma EBV DNA content. Receiver operating characteristic (ROC) curves demonstrated that plasma CCL27 levels had a sensitivity of 67.00%, a specificity of 73.10%, and an area under the ROC of 0.725 (95% confidence interval [CI]: 0.657–0.793) for distinguishing between NPC patients and VCA-IgA–positive healthy donors. Further analysis showed that CCL27 levels could distinguish between early stage NPC patients and VCA-IgA–positive healthy donors with an area under the ROC of 0.712 (95% CI: 0.560–0.865), a sensitivity of 59.80%, and a specificity of 84.60%.ConclusionsChemokine CCL27 could successfully identify NPC patients within a VCA-IgA–positive population.
Highlights
To investigate the predictive value of chemokine C-C Motif Chemokine Ligand 27 (CCL27) for identifying early stage nasopharyngeal carcinoma (NPC) patients within a population seropositive for Epstein-Barr virus (EBV) capsid antigen-specific IgA (VCA-IgA)
The inclusion criteria for NPC were as follows: all of the patients met the diagnostic criteria for NPC (TNM staging defined by the 2009 Union for International Cancer Control/American Joint Committee on Cancer staging system for NPC), and all 104 NPC patients were seropositive for EBV VCA-IgA
The results show that CCL27 levels were significantly higher in EBV-infected individuals (i.e., NPC patients and VCA-IgA–positive healthy donors) than in uninfected normal subjects
Summary
To investigate the predictive value of chemokine CCL27 for identifying early stage nasopharyngeal carcinoma (NPC) patients within a population seropositive for Epstein-Barr virus (EBV) capsid antigen-specific IgA (VCA-IgA). Because EBV infection is closely associated with the occurrence of NPC, EBV-related biomarkers, such as EBV viral capsid antigen-specific IgA (VCA-IgA), have been widely used in NPC screening. After the last follow-up, only 174 of the 12,629 subjects were confirmed to have NPC (positive predictive value of 1.4%). In large population screens in Taiwan [5] and Hong Kong [6], the VCA-IgA–positive rate was 3–6% and the NPC-positive rate was 1.5–4.4% [7]. VCA-IgA and EBNA1-IgA can be used effectively to screen for NPC, but the positive predictive value for NPC is low [8]. It is crucial to find new biomarkers that can identify NPC patients in the VCA-IgA–positive population
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