Abstract
Nasopharyngeal carcinoma (NPC) is a unique tumour which is endemic in Southern China including Hong Kong. While the treatment results for early disease are encouraging, patients with advanced cancer are uniformly associated with poor prognosis. Epstein-Barr virus (EBV), the first virus related to the development of human malignancy, plays an important role in the carcinogenesis of the disease. Over the past decades, researchers have been trying to identify EBV associated biomarkers which allows early diagnosis as well as accurate monitoring of treatment response. With the development of real time quantitative polymerase chain reaction, plasma EBV DNA has been studied with much enthusiasms for its potential role in the management of patients with NPC. Since then, numerous reports have been published regarding the applications of plasma EBV-DNA for early diagnosis, monitoring of treatment response after radiotherapy or surgery, and as a prognosticator predicting oncological results after curative therapy for primary disease or palliative treatments for patients with recurrent/metastatic cancer. On-going studies are performed to investigate its potential use in the screening of at-risk populations in the endemic geographic regions. In the future, it may allow pre-treatment risk stratification for individual patients, so that personalization of treatment protocols can be achieved with potentially better oncological outcome.
Highlights
Since the first report in 1910, nasopharyngeal carcinoma (NPC) has been recognized for over 100 years
Epstein-Barr virus (EBV) infection was shown to be an early event in NPC, and studies have demonstrated the presence of EBV deoxyribonucleic acid (DNA), ribonucleic acid (RNA), and proteins in the majority of the NPC cancer cells [13,14,15], origination of tumour cells from the EBV-infected cell [16], as well as the presence of high levels of EBV antibodies in patient with NPC [17,18,19] and in healthy individuals who subsequently developed NPC [20,21]
Afterwards, the plasma Epstein-Barr virus DNA (EBV-DNA) concentration dropped rapidly with a median half-life of 3.8 days. These findings showed that the clearance rate of the EBV-DNA may reflect the radio sensitivity of the tumour, which in turn may have treatment implications in the future
Summary
Since the first report in 1910, nasopharyngeal carcinoma (NPC) has been recognized for over 100 years. According to the Hong Kong Cancer Registry, NPC ranked 7th in the most common new malignancy for both gender In these areas, majority of the tumors are undifferentiated carcinoma (World Health Organization [WHO] type III). There are two major clusters, the BamHI fragment H rightward open reading frame 1 (BHRF1) and BamHI-A rightward transcript (BART), coding for 25 precursors and 44 mature viral-encoded microRNAs. EBV infection was shown to be an early event in NPC, and studies have demonstrated the presence of EBV deoxyribonucleic acid (DNA), ribonucleic acid (RNA), and proteins in the majority of the NPC cancer cells [13,14,15], origination of tumour cells from the EBV-infected cell [16], as well as the presence of high levels of EBV antibodies in patient with NPC [17,18,19] and in healthy individuals who subsequently developed NPC [20,21]. J Mol Biomark Diagn S5: 004. doi:10.4172/2155-9929.S5-004
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