Value of plasma Epstein-Barr virus DNA detection in the screening of nasopharyngeal carcinoma and its clinical application in non-high-risk areas
10.3760/cma.j.cn114452-20210705-00412
- VernacularTitle:非高发区人群中血浆EB病毒DNA对鼻咽癌的筛查及临床应用价值
- Author:
Qiao HE
1
;
Xianbing LI
;
Luona LI
;
Yecai HUANG
;
Jie ZHOU
;
Qiuju WANG
;
Mei LAN
;
Hao LUO
;
Lichun WU
;
Li ZHANG
;
Xiaoyu SONG
;
Mu YANG
;
Dongsheng WANG
Author Information
1. 四川省肿瘤医院·研究所 四川省癌症防治中心检验科 电子科技大学医学院，成都 610000
- Keywords:
Nasopharyngeal neoplasms;
Epstein-Barr virus;
DNA;
Clinical laboratory techniques
- From:
Chinese Journal of Laboratory Medicine
2022;45(4):381-387
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of plasma Epstein-Barr virus (EBV) DNA detection in the screening of nasopharyngeal carcinoma (NPC) and its clinical application in non-high-risk areas.Methods:Plasma EBV DNA results in 1 153 newly diagnosed nasopharyngeal carcinoma patients who were treated in Sichuan Cancer Hospital from 2015 to 2020 and 244 healthy control cases with matched sex and age were retrospectively analyzed. EBV DNA were detected by quantitative real-time PCR. Positive rate of EBV DNA was determined by the cutoff value of 400 (≥400 copies/ml as positive) and optimization threshold method (presence of S amplification curve as positive). Further analyses were conducted to compare EBV DNA load in different clinical stage, TNM stage and regions distribution characteristics. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of the cutoff value of 400 and optimization threshold method for NPC.Results:Compared with healthy controls, EBV DNA increased significantly in newly diagnosed NPC patients ( P<0.001). Both evaluation methods revealed that the EBV DNA positive percentage increased with TNM and clinical stage ( P<0.001). With 400 copies/ml as cutoff value, the diagnostic sensitivity and specificity were 40.85% and 100%, respectively. The area under the curve was 0.704 (95% CI 0.676-0.733, P<0.001). Evaluated by the optimization threshold method, the sensitivity and specificity could improve to 82.0% and 99.2%, respectively, and the area under the curve reached 0.910 (95% CI 0.894-0.924, P<0.001). Conclusions:In the low prevalence area of nasopharyngeal carcinoma, the sensitivity for diagnosis of nasopharyngeal carcinoma is only 40.9% by the 400 copies/ml cutoff value method. The optimization threshold method is a better choice to improve the diagnostic sensitivity without lowering the diagnostic specificity.
