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Distant Metastases And Poor Prognoses Indicated By Epstein Barr Virus DNA 1 In Nasopharyngeal Cancer

There is a considerably higher risk of developing distant metastases and lower rate of survival among patients with nasopharyngeal cancer when Epstein- Barr Virus DNA is detected in the peripheral blood cells, according to research from Taiwan.

Researchers from Medical College and other health departments in Taiwan designed a study to determine whether the presence of the Epstein-Barr virus in the peripheral blood cells (PBC) can act as a prognostic factor for nasopharyngeal cancer.

Participants included 124 patients with nasopharyngeal cancer with no evidence of distant metastases and 114 healthy volunteers with serologically positive indications of Epstein-Barr viral infection who all provided peripheral blood samples.

Once the plasma and erythrocytes were separated, the DNA was extracted from the PBC's. It then underwent analysis by nested polymerase chain reactions using primers, which are specific to Epstein Barr virus nuclear antigen 1 (EBNA-1).

All patients were treated by radiotherapy with or without chemotherapy. The Kaplan-Meier method and Cox proportional hazards model served to analyse the survival rate through clinical parameters and status of EBNA-1 in PBC's.

Positive rates of EBNA-1 in PBC's of patients with nasopharyngeal cancer and healthy volunteers were 71 percent and 14 percent, respectively. There was no significant difference indicted between the 88 patients who were either EBNA-1-positive and the 36 who were EBNA-1 negative.

After a 38-month median follow-up period, distant metastases developed in 29 of the 88 patients who were positive to EBNA-1 and only one of the 36 patients who were negative to EBNA-1.

Patients who were EBNA-1-positive had a lower overall metastases-free and progression survival rate estimated by Kaplan-Meier by comparison with those who were EBNA-1-negative. The result was confirmed by multivariate Cox analysis.
Journal of Clinical Oncology 2001 Vol 19 Issue 10 pp 2607-2615 "Detection of Epstein-Barr Virus DNA in the Peripheral-Blood Cells of Patients With Nasopharyngeal Carcinoma: Relationship to Distant Metastasis and Survival"

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