Diagnostic value of serum EBV‐DNA quantification and antibody to viral capsid antigen in nasopharyngeal carcinoma patients

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Abstract
We compared the amount of serum Epstein‐Barr virus DNA (EBV‐DNA) detected in patients with nasopharyngeal carcinoma (NPC) in a high‐incidence area, represented by Taiwan, and a low‐incidence area, represented by Japan, using real‐time quantitative PCR. The median serum EBV‐DNA value in 41 Japanese NPC cases was 5450 copies/ml, and that in in 23 Taiwanese cases was 2125 copies/ml. The median serum EBV‐DNA value in all 64 NPC cases was significantly higher than in control groups. Using receiver‐operating‐characteristic (ROC) curves, the sensitivity and specificity of EBV‐DNA quantification were determined (cut‐off point, 6.87 copies/ml; sensitivity, 0.855; specificity, 0.885) and compared with those of EBV‐viral‐capsid‐antigen (VCA) titers; the results showed that EBV‐DNA was a more sensitive and specific parameter than EBV‐VCA titer. Then, we analyzed 19 NPC patients in whom recurrence developed (11 Japanese and 8 Taiwanese), and 26 NPC patients in continuous remission. Although there was no significant difference in EBV‐DNA values between Japanese and Taiwanese patients, the value was significantly higher in the 19 patients with recurrence than in those in remission. ROC analysis again revealed a higher diagnostic value of EBV‐DNA than EBV‐VCA. These results suggest EBV‐DNA is a more reliable tumor marker than EBV‐VCA in both high‐incidence and low‐incidence areas of NPC.