Abstract
BackgroundThe identification of effective prognosis biomarkers for nasopharyngeal carcinoma (NPC) is crucial to improve treatment and patient outcomes. In the present study, we have attempted to evaluate the correlation between pre-treatment plasmatic Epstein-Barr virus (EBV) DNA load and the conventional prognostic factors in Moroccan patients with NPC.MethodsThe present study was conducted on 121 histologically confirmed NPC patients, recruited from January 2017 to December 2018. Circulating levels of EBV DNA were measured before therapy initiation using real-time quantitative PCR.ResultsOverall, undifferentiated non-keratinizingcarcinoma type was the most common histological type (90.1 %), and 61.8 % of patients were diagnosed at an advanced disease stage (IV). Results of pre-treatment plasma EBV load showed that 90.9 % of patients had detectable EBV DNA, with a median plasmatic viral load of 7710 IU/ml. The correlation between pre-treatment EBV DNA load and the conventional prognostic factors showed a significant association with patients’ age (p = 0.01), tumor classification (p = 0.01), lymph node status (p = 0.003), metastasis status (p = 0.00) and overall cancer stage (p = 0.01). Unexpectedly, a significant higher level of pre-treatment EBV DNA was also found in plasma of NPC patients with a family history of cancer (p = 0.04). The risk of NPC mortality in patients with high pretreatment EBVDNA levels was significantly higher than that of those with low pre-treatment plasma EBV-DNA levels (p < 0.05). Furthermore, patients with high pre-treatment EBV-DNA levels (≥ 2000, ≥ 4000) had a significant low overall survival (OS) rates (p < 0.05). Interestingly, lymph node involvement, metastasis status and OS were found to be the most important factors influencing the EBV DNA load in NPC patients.ConclusionsThe results of the present study clearly showed a high association between pre-treatment EBV DNA load, the crucial classical prognostic factors (T, N, M and disease stage) of NPC and OS, suggesting that pre-treatment EBV DNA can be a useful prognostic biomarker in clinical decision-making and improving NPC treatment in Morocco.
Highlights
Nasopharyngeal carcinoma (NPC), one of the most common head and neck cancers, has a streaking geographical distribution; rare in most parts of the world, it is endemic in southern parts of China and other parts of south-east Asia (Malaysia, Indonesia, Vietnam), with an incidence varying between 30 and 80 cases per 100,000 per year
The World Health Organization (WHO) has classified nasopharyngeal carcinoma (NPC) into the three subtypes based on histology: the keratinizing squamous cell carcinoma, the differentiated non-keratinizing carcinoma, and the undifferentiated non-keratinizing carcinoma
As NPC is characterized by a bimodal age distribution in North-African countries, we analyzed the prognostic value of Epstein-Barr virus (EBV) DNA load in NPC patients stratified by age (≤ 30 vs. > 30 year of age)
Summary
Nasopharyngeal carcinoma (NPC), one of the most common head and neck cancers, has a streaking geographical distribution; rare in most parts of the world, it is endemic in southern parts of China and other parts of south-east Asia (Malaysia, Indonesia, Vietnam), with an incidence varying between 30 and 80 cases per 100,000 per year. A bimodal age distribution characterizes the population of the Maghreb, with a first peak incidence occurring at 15–25 and a second one at 50– 59 years of age, while only one peak around ages 45– 59 is observed in endemic areas for NPC [4]. The identification of effective prognosis biomarkers for nasopharyngeal carcinoma (NPC) is crucial to improve treatment and patient outcomes. We have attempted to evaluate the correlation between pre-treatment plasmatic Epstein-Barr virus (EBV) DNA load and the conventional prognostic factors in Moroccan patients with NPC
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