Clinical, subclinical characteristics and relationship of serum EBV-DNA levels in patients with stages III-IVA nasopharyngeal carcinoma at National Cancer Hospital

Nguyen Van Dang, Pham Van Thang

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Abstract

Nasopharyngeal carcinoma is a common cancer in the head and neck area. The disease has a very clear geographical factor and is closely related to the Epstein Barr virus. A cross-sectional study was performed on 118 patients with stage III-IVA nasopharyngeal cancer from June 2023 to June 2024 at the Vietnam national cancer hospital to describe various clinical and subclinicalcharacteristics and the relationship with serum EBV-DNA. The appearance of neck lymph node is the most common symptom, accounting for 61.8%. On magnetic resonance imaging, invasion of the skull base, cervical spine, and paranasal cavity accounts for the highest rate at 59.3%. T3 tumors are the most common with 34.7%; N2 lymph node metastasis is the most common with 56.8%. Stages III and IVA are 57.6% and 42.4%, respectively. 91% of patients had positive serum EBV-DNA quantification. EBV-DNA concentration gradually increased with disease stage, which was significantly related to the level of lymph node metastasis N (p < 0.05).

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References

1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3): 209-249. https://doi.org/10.3322/caac.21660.
2. Yexun Song, et al. The global, regional, national burden of nasopharyngeal cancer and its attributable risk factors (1990–2019) and predictions to 2035. Cancer Medicine. 2022; 11:4310–4320.
3. Lee VH et al. The addition of pretreatment plasma Epstein-Barr virus DNA into the eighth edition of nasopharyngeal cancer TNM stage classification. Int J Cancer. 2019; 144(7):1713. Epub 2018 Dec 24.
4. Li W, Yang C, Lv Z, Li J, et al. (2021). Integrating pre-and post-treatment plasma Epstein-Barr virus DNA levels for better prognostic prediction of nasopharyngeal carcinoma. J. Cancer 12, 2715–2722. doi: 10.7150/jca.56397.
5. Vu Nguyen Quynh Anh, et al. Validation of a Highly Sensitive qPCR Assay for the Detection of Plasma Cell-Free Epstein-Barr Virus DNA in Nasopharyngeal Carcinoma Diagnosis. Cancer Control. 2020 Jul-Aug; 27(3): 1073274820944286. doi: 10.1177/1073274820944286.
6. Pan JJ, Ng WT, Zong JF, et al. Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity modulated radiotherapy. Cancer. Feb 15 2016; 122(4): 546-58. doi:10.1002/cncr.29795.
7. Cancer Today 2022. Nasopharynx. https://gco.iarc.who.int/media/globocan/factsheets/populations/704-viet-nam-fact-sheet.pdf.
8. Lee AW, Foo W, Law SC, et al. Nasopharyngeal carcinoma: presenting symptoms and duration before diagnosis. Hong Kong medical journal - Xianggang. Hong Kong Academy of Medicine. Dec 1997; 3(4): 355-361.
9. Hoàng Đào Chinh, Lê Văn Quảng. Giá trị tiên lượng của tổng thể tích u ở bệnh nhân ung thư vòm mũi họng giai đoạn III-IVB. Tạp chí nghiên cứu y học. 2021. 137(1): 84-92.
10. Mengxing Wu et al. MRI-based clinical radiomics nomogram may predict the early response after concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma. Front. Oncol. Volume 13 - 2023 doi.org/10.3389/fonc.2023.1192953.
11. Johan S. Nilsson, Ola Forslund, Fredrik C. Andersson. Intralesional EBV-DNA load as marker of prognosis for nasopharyngeal cancer. Scientific Reports. Volume 9, Article number: 15432 (2019). doi.org/10.1038/s41598-019-51767-9.
12. Quiao He, et al. A promising predictive biomarker combined EBV NDA with PNI for nasopharyngeal carcinoma in nonendemic area of China. Scientific Reports. 2023 Jul 20; 13(1): 11700. doi: 10.1038/s41598-023-38396-z.
13. Zhao F., Liu X et al. Levels of plasma Epstein Barr virus DNA prior and subsequent to treatment predicts the prognosis of nasopharyngeal carcinoma. Oncol Lett. 2015. 10(5), 2888-2894.
14. Lee V.H, Kwong D.L et al (2017). Prognostication of serial post- intensity modulated radiation therapy undetectable plasma EBV-DNA for nasopharyngeal carcinoma. Oncotarget, 8(3). 5292-5308.