A possible prognostic role of immunoglobulin-G antibody against recombinant Epstein-Barr virus BZLF-1 transactivator protein ZEBRA in patients with nasopharyngeal carcinoma
- 1 November 1994
- Vol. 74 (9), 2414-2424
- https://doi.org/10.1002/1097-0142(19941101)74:9<2414::aid-cncr2820740905>3.0.co;2-8
Abstract
Background. Epstein-Barr virus BZLF-1 replication activator (ZEBRA) is involved in the switch from viral latency to a productive cycle. Previous immunofluorescent study has shown that patients with nasopharyngeal carcinoma (NPC) have elevated immunoglobulin-G (IgG) antibody titres against recombinant ZEBRA protein (ZEBRA/IgG). Methods. The prognostic role of ZEBRA/IgG was further investigated by enzyme-linked immunosorbent assay (ELISA) in 110 NPC patients under long period of clinical follow-up. Results. Ninety-seven percent (85 of 88) of the patients with NPC had significantly higher ZEBRA/IgG titres (geometrical mean titre, i. e., GMT = 8397) than normal Chinese individuals (GMT = 233 and P < 0.0001). Based on Kaplan-Meier analysis, the actuarial survival in patients with high ZEBRA/IgG titres (25%) after radiotherapy was significantly lower than that of those with low (76%; P = 0.0008) or intermediate titres (62%; P = 0.0036), although the titres taken before treatment did not bear such a relationship. Subdividing the patients into either individual UICC or Ho's stages, those with late-stage disease (UICC Stage 4 and Ho's Stages 3 and 4) and with high ZEBRA/IgG titres also had poorer prognosis than those with disease of the same stages but who had low titres. Poor prognosis in those with high titres could be associated with a high risk of distant metastasis because consistent titre increase was found in the majority of patients who later developed distant metastasis either in the lung or liver. Only a minimal increase was found in patients with recurrence in the cervical lymph nodes. No consistent increase was observed, however, in patients whose disease was in remission or the majority of those with bone metastasis or local recurrence in the nasopharynx. Conclusion. The postradiotherapy ZEBRA/IgG titre could be a potentially useful marker for differentiating NPC patients with poor prognosis from those at high risk for the development of distant metastasis to the lung or liver.Keywords
This publication has 72 references indexed in Scilit:
- Expression of the Epstein-Barr virus latent membrane protein in nasopharyngeal carcinoma biopsy specimensHuman Pathology, 1993
- Description of an In Situ Hybridization Methodology for Detection of Epstein-Barr Virus RNA in Paraffin-Embedded Tissues, with a Survey of Normal and Neoplastic TissuesDiagnostic Molecular Pathology, 1992
- EBV Humoral Immunology: 1966–1990Published by Springer Science and Business Media LLC ,1991
- Selection and production by genetechnological methods of medically relevant EBV-related antigensPublished by Springer Science and Business Media LLC ,1985
- Epstein-Barr-virus-specific IgA and IgG serum antibodies in nasopharyngeal carcinomaBritish Journal of Cancer, 1976
- Epstein‐barr virus‐specific IgA serum antibodies as an outstanding feature of nasopharyngeal carcinomaInternational Journal of Cancer, 1976
- Demonstration of epstein‐barr virus‐associated nuclear antigen in nasopharyngeal carcinoma cells from fresh biopsiesInternational Journal of Cancer, 1974
- DNA of Epstein-Barr Virus Detected in Tissue of Burkitt's Lymphoma and Nasopharyngeal CarcinomaProceedings of the National Academy of Sciences of the United States of America, 1973
- EB Viral Genomes in Epithelial Nasopharyngeal Carcinoma CellsNature New Biology, 1973
- Epstein–Barr Virus in Burkitt's Lymphoma and Nasopharyngeal Carcinoma: EBV DNA in Biopsies of Burkitt Tumours and Anaplastic Carcinomas of the NasopharynxNature, 1970