Nasopharyngeal carcinoma: Significance of changes in epstein‐barr virus‐related antibody patterns following therapy

Abstract

AbstractSera were collected at intervals of 3 to 8 months over a 4‐ to 5‐year period from more than 103 patients with nasopharyngeal carcinomas (NPC) and examined for their spectra and titers of antibodies to Epstein‐Barr virus (EBV)‐related antigens. They were titrated for IgG, IgA and IgM antibodies to EB viral capsid antigen (VCA), for IgG and IgA antibodies to the D (diffuse) and R (restricted) components of the EBV‐determined early antigen (EA) complex, and for antibodies to the EBV‐associated nuclear antigen (EBNA). In the as yet untreated patients the incidences and titers of most of the antibodies increased with the stage of the disease; i.e., essentially with the total tumor burden. Such increases were observed in individual patients whose disease ultimately progressed to death, at times well in advance of the recognition of relapses or metastases. Increases were not noted or were only minor and delayed in some fatal cases if the tumor extended to the cranial cavity in the absence of significant involvement of cervical lymph nodes. In contrast, patients who responded well to therapy and remained clinically free of disease during the 4‐ or 5‐year observation period after, at most, early minor relapses, showed gradual, steady declines in the titers of all antibodies except anti‐EBNA. Thus, VCA‐specific IgA and D‐specific IgA and IgG became undetectable in time in many of the patients. In several long‐term survivors the declines were arrested at given levels or a reversal to increasing titers was noted which was followed in time by detection of a recurrent tumor or metastases in some cases, but not in others who remain under close observation. It would appear that serologic monitoring of NPC patients may warn of recurrent tumor activity well before it becomes clinically evident.