Development of a Clinicomolecular Risk Stratification System for Non-Metastatic Nasopharyngeal Carcinoma Using Epstein-Barr Virus DNA and TNM Stage in 9,160 Endemic Cases from Southern China

2018 ◽  
Author(s):  
Fo-Ping Chen ◽  
Guan-Qun Zhou ◽  
Ying-Shan Luo ◽  
Kuan Rui Lloyd Tan ◽  
Li Lin ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Risk Stratification ◽  
Epstein Barr Virus ◽  
Southern China ◽  
Tnm Stage ◽  
Barr Virus ◽  
Metastatic Nasopharyngeal Carcinoma ◽  
Epstein Barr ◽  
Stratification System ◽  
Risk Stratification System

Development of a clinicomolecular risk stratification system for nonmetastatic nasopharyngeal carcinoma using Epstein–Barr virus DNA and TNM stage: A “Big data” analysis of 9,160 endemic cases.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6043-6043
Author(s):  
Fo-Ping Chen ◽  
Guan-Qun Zhou ◽  
Ying-Shan Luo ◽  
Kuan Rui Lloyd Tan ◽  
Sze Huey Tan ◽  
...  
Keyword(s):  
Big Data ◽  
Nasopharyngeal Carcinoma ◽  
Risk Stratification ◽  
Epstein Barr Virus ◽  
Tnm Stage ◽  
Barr Virus ◽  
Stage Classification ◽  
Epstein Barr ◽  
Stratification System ◽  
Risk Stratification System

6043 Background: To construct a clinicomolecular index integrating circulating Epstein-barr virus (cfEBV) DNA with T- and N- categories for better prognostication in nasopharyngeal carcinoma (NPC). Methods: Clinical and treatment records of 9,160 biopsy-proven, non-metastatic NPC cases were identified from an institutional “Big-data” platform. Decision tree modeling (DTM), recursive partitioning analysis (RPA) and adjusted hazard ratio (AHR) methods were used to generate clinicomolecular risk models. Outcome prediction of the models were compared against 8th edition TNM stage and two RPA-original models. Results: We observed linearity between cfEBV DNA and DFS; cfEBV DNA of > 2,000 copies was consistent for risk discretisation (HR > 1.0) for DFS, OS and DMFS in our cohort of 9,160 patients. DTM, RPA-new and AHR modelling using a two-tiered stratification by cfEBV DNA (≤2,000 and > 2,000 copies) and T- and N- categories yielded five risk groups with significantly disparate DFS (P < 0.001 for all subgroup comparisons). AHR model outperformed all other models and the TNM stage classification with better hazard consistency, hazard discrimination, explained variation, sample size balance and likelihood difference. Importantly, our clinicomolecular AHR groupings were significantly associated with the efficacy of different therapeutic regimes. Outcomes were comparable between concurrent chemoradiotherapy and intensity-modulated radiotherapy (IMRT) and IMRT alone for AHR1-2 (3-y DFS [AHR1] = 96.2% [IMRT] vs 95.3% [chemo-IMRT]; 3-y DFS [AHR2] = 91.1% vs 90.4%). Neoadjuvant chemotherapy and chemo-IMRT was superior to chemo-IMRT alone for AHR4-5 (AHRDFS 0.77[0.65-0.93], P = 0.005; 0.77[0.61-0.97], P = 0.027), but not for AHR3 (AHRDFS 1.07[0.86-1.34]). Conclusions: Here, we present a robust clinicomolecular risk stratification system that outperforms the TNM stage classification in non-metastatic NPC. Our clinicomolecular model is associated with the efficacy of different therapeutic regimes.

scholarly journals Plasma Epstein-Barr virus DNA and risk of nasopharyngeal carcinoma in a prospective seropositive population

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen-Jie Chen ◽  
Wen-Na Xu ◽  
Hai-Yun Wang ◽  
Xiao-Xia Chen ◽  
Xue-Qi Li ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Epstein Barr Virus ◽  
Screening Program ◽  
Southern China ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Barr Virus ◽  
Ebv Dna ◽  
Epstein Barr

Abstract Objective Plasma Epstein-Barr virus (EBV) DNA is considered a biomarker for nasopharyngeal carcinoma (NPC). However, its long-term role in NPC development is unclear. Materials and methods A total of 1363 participants seropositive for EBV VCA-IgA and EBNA1-IgA in a community-based NPC screening program in southern China were tested for plasma EBV DNA levels by real-time qPCR between 2008 and 2015. New NPC cases were confirmed by active follow-up approach and linkage to local cancer registry through the end of 2016. Cox proportional hazards regression analysis was performed to calculate the hazard ratios (HRs) for NPC risk with plasma EBV DNA. Results Thirty patients were newly diagnosed during a median 7.5 years follow-up. NPC incidence increased with the plasma EBV DNA load ranging from 281.46 to 10,074.47 per 100,000 person-years in participants with undetectable and ≥ 1000 copies/ml levels; the corresponding cumulative incidence rates were 1.73 and 50%. Furthermore, plasma EBV DNA loads conferred an independent risk for NPC development after adjustment for other risk factors, with HRs of 7.63 for > 3–999 copies/ml and 39.79 for ≥1000 copies/ml. However, the HRs decreased gradually after excluding NPC cases detected in the first 2 to 3 years and became statistically nonsignificant by excluding cases detected during the first 4 years. Conclusion Elevated plasma EBV DNA can predict NPC risk over 3 years. Monitoring plasma EBV DNA can be used as a complementary approach to EBV serological antibody-based screening for NPC.

scholarly journals Decreased oral Epstein-Barr virus DNA loads in patients with nasopharyngeal carcinoma in Southern China: A case-control and a family-based study

2018 ◽  
Vol 7 (7) ◽  
pp. 3453-3464 ◽  
Author(s):  
Wen-Qiong Xue ◽  
Yong-Qiao He ◽  
Xiao-Yu Liao ◽  
Fang-Fang Li ◽  
Ya-Fei Xu ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Epstein Barr Virus ◽  
Southern China ◽  
Case Control ◽  
Barr Virus ◽  
Epstein Barr ◽  
Family Based

scholarly journals Smoking can increase nasopharyngeal carcinoma risk by repeatedly reactivating Epstein‐Barr Virus: An analysis of a prospective study in southern China

2019 ◽  
Vol 8 (5) ◽  
pp. 2561-2571 ◽  
Author(s):  
Ting Hu ◽  
Chu‐Yang Lin ◽  
Shang‐Hang Xie ◽  
Geng‐Hang Chen ◽  
Yu‐Qiang Lu ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Prospective Study ◽  
Epstein Barr Virus ◽  
Southern China ◽  
Barr Virus ◽  
Epstein Barr ◽  
A Prospective Study ◽  
Carcinoma Risk

scholarly journals Epstein-Barr Virus EBNA-2 Polymorphic Patterns in Nasopharyngeal Carcinoma in Southern China

Intervirology ◽  
2015 ◽  
Vol 58 (6) ◽  
pp. 386-392
Author(s):  
Guocai Wu ◽  
Xia Liu ◽  
Song Liu ◽  
Jun Shu ◽  
Zhifu Sun ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Epstein Barr Virus ◽  
Southern China ◽  
Barr Virus ◽  
Epstein Barr

scholarly journals Early Detection of Nasopharyngeal Carcinoma

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Keiji Tabuchi ◽  
Masahiro Nakayama ◽  
Bungo Nishimura ◽  
Kentaro Hayashi ◽  
Akira Hara
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Early Detection ◽  
Epstein Barr Virus ◽  
Clinical Presentation ◽  
Southern China ◽  
Squamous Cell Carcinomas ◽  
Treatment Results ◽  
Barr Virus ◽  
Associated Malignancy ◽  
Epstein Barr

Nasopharyngeal carcinoma (NPC) is a unique disease with a clinical presentation, epidemiology, and histopathology differing from other squamous cell carcinomas of the head and neck. NPC is an Epstein-Barr virus-associated malignancy with a marked racial and geographic distribution. Specifically, it is highly prevalent in southern China, Southeast Asia, and the Middle East. To date, most NPC patients have been diagnosed in the advanced stage, but the treatment results for advanced NPC are not satisfactory. This paper provides a brief overview regarding NPC, with the focus on the early detection of initial and recurrent NPC lesions.

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