Abstract
IntroductionNasopharyngeal carcinoma (NPC) is a multifactorial disease with genetic, viral, environmental and lifestyle-related risk factors. Epstein–Barr virus (EBV) can promote the oncogenic transformation of an infected cell into malignant. EBV encodes many stimulating products including Epstein–Barr virus nuclear antigen-1 (EBNA-1) which plays a key role in the regulation of gene expression and replication of the genome in the latent period of infection. EBNA-1 in serum and tumour tissue of NPC patients correlates with NPC prognosis. Moreover, the presence of EBV DNA in serum samples from NPC patients’ blood circulation can be used as an early marker in the diagnosis of NPC.ObjectiveThe objective of this study was to find effective methods for monitoring the progress of NPC patients undergoing radiotherapy and therapeutic efficacy by observing the changes in EBV DNA in serum and saliva.MethodologyThe pre-experimental design compared blood and saliva taken from a pre-test and post-test group of NPC patients before and after radiation therapy. The concentration of EBV DNA was measured in the serum and saliva after amplification using quantitative polymerase chain reaction (qPCR) with compatible primers for the EBNA-1 gene. The data were statistically analysed by paired T-test.ResultsHighly significant (p = 0.0001) increase in cycle threshold qPCR and decrease in the mean concentration of EBV DNA (p = 0.0001) were observed in serum samples, but no significant changes were observed in saliva.ConclusionsThe results suggest that EBV DNA in serum can be used as the gold standard and a marker for monitoring the response to radiation therapy in NPC patients, whereas the examination of EBV DNA from saliva samples is not accurate and thus, not appropriate.
Highlights
Nasopharyngeal carcinoma (NPC) is a multifactorial disease with genetic, viral, environmental and lifestyle-related risk factors
Highly significant (p = 0.0001) increase in cycle threshold quantitative polymerase chain reaction (qPCR) and decrease in the mean concentration of Epstein–Barr virus (EBV) DNA (p = 0.0001) were observed in serum samples, but no significant changes were observed in saliva
The results suggest that EBV DNA in serum can be used as the gold standard and a marker for monitoring the response to radiation therapy in NPC patients, whereas the examination of EBV DNA from saliva samples is not accurate and not appropriate
Summary
Nasopharyngeal carcinoma (NPC) is a multifactorial disease with genetic, viral, environmental and lifestyle-related risk factors. EBV encodes many stimulating products including Epstein–Barr virus nuclear antigen-1 (EBNA-1) which plays a key role in the regulation of gene expression and replication of the genome in the latent period of infection. Nasopharyngeal carcinoma (NPC) is a multifactorial disease with primary genetic, racial, environmental, lifestyle-related risk factors including smoking, food intake and the uptake of carbon particles; the Epstein–Barr virus (EBV) is closely related to the pathogenesis of NPC [1]. Genetic factors are thought to play a role in the pathogenesis of NPC in high incidence populations of certain Asian (China, India, Vietnam, Thailand, Malaysia, Singapore and Indonesia) and African countries (Morocco, Algeria, Tunisia and Ghana [3, 4]). In 2018, there were 60,558 new NPC cases (47.7% of total global cases) and 31,413 NPC-related deaths in China [1, 5]
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