Prospective Study of Tailoring Whole-Body Dual-Modality [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography With Plasma Epstein-Barr Virus DNA for Detecting Distant Metastasis in Endemic Nasopharyngeal Carcinoma at Initial Staging

2013 ◽  
Vol 31 (23) ◽  
pp. 2861-2869 ◽  
Author(s):  
Lin-Quan Tang ◽  
Qiu-Yan Chen ◽  
Wei Fan ◽  
Huai Liu ◽  
Lu Zhang ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Epstein Barr Virus ◽  
Distant Metastases ◽  
Emission Tomography ◽  
Barr Virus ◽  
Positron Emission ◽  
Pet Ct ◽  
Risk Patients ◽  
Ebv Dna ◽  
Epstein Barr

Purpose To evaluate which patients with nasopharyngeal carcinoma (NPC) obtained the greatest benefits from the detection of distant metastasis with [18F]fluorodeoxyglucose positron emission tomography and computed tomography (PET/CT) combined with plasma Epstein-Barr virus (EBV) DNA levels. Patients and Methods Consecutive patients with NPC were prospectively enrolled. PET/CT, conventional work-up (CWU), and quantification of plasma EBV DNA were performed before treatment. The accuracy of these strategies for distant metastases was assessed. The costs of the diagnostic strategies were compared. Results Eighty-six (14.8%) of the 583 eligible patients were found to have distant metastases; 71 patients (82.6%) by PET/CT and 31 patients (36.0%) by CWU. In the multivariable analysis, advanced N stage (odds ratio, 2.689; 95% CI, 1.894 to 3.818) and pretreatment EBV DNA level (odds ratio, 3.344; 95% CI, 1.825 to 6.126) were significant risk factors for distant metastases. PET/CT was not superior to CWU for detecting distant metastases in very low–risk patients (N0-1 with EBV DNA < 4,000 copies/mL; P = .062), but was superior for the low-risk patients (N0-1 with EBV DNA ≥ 4,000 copies/mL and N2-3 with EBV DNA < 4,000 copies/mL; P = .039) and intermediate-risk patients (N2-3 disease with EBV DNA ≥ 4,000 copies/mL; P < .001). The corresponding patient management changes based on PET/CT were 2.9%, 6.3%, and 16.5%, respectively. The costs per true-positive case detected by PET/CT among these groups were ¥324,138 (≈$47,458), ¥96,907 (≈$14,188), and ¥34,182 (≈$5,005), respectively. Conclusion PET/CT detects more distant metastases than conventional staging in patients with NPC. The largest benefit in terms of cost and patient management was observed in the subgroup with N2-3 disease and EBV DNA ≥ 4,000 copies/mL.

scholarly journals Maximal standard uptake values of 18F-fluoro-2-deoxy-D-glucose positron emission tomography compared with Epstein-Barr virus DNA as prognostic indicators in de novo metastatic nasopharyngeal carcinoma patients

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xue-Song Sun ◽  
Yu-Jing Liang ◽  
Sai-Lan Liu ◽  
Qiu-Yan Chen ◽  
Shan-Shan Guo ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Nasopharyngeal Carcinoma ◽  
Epstein Barr Virus ◽  
De Novo ◽  
Emission Tomography ◽  
Barr Virus ◽  
Positron Emission ◽  
Metastatic Nasopharyngeal Carcinoma ◽  
Ebv Dna ◽  
Epstein Barr

Abstract Background This study aimed to evaluate the prognostic value of maximal standard uptake values (SUVmax) of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (PET) comparing with Epstein-Barr virus (EBV) DNA levels in de novo metastatic nasopharyngeal carcinoma (NPC) patients. Methods From December 2006 to December 2016, 253 de novo metastatic NPC patients assessed by PET/ computed tomography were involved in current study. SUVmax-T, SUVmax-N, and SUVmax-M referred to the SUVmax at the primary tumor, cervical lymph nodes, and metastatic lesions respectively. Overall survival (OS) was the primary endpoint. Result Patients who died during the follow-up had significantly higher SUVmax-N, SUVmax-M, and EBV DNA level than those in the patients who were alive. SUVmax-N and SUVmax-M were positively correlated with EBV DNA level. The cut-off values of SUVmax-T, SUVmax-N, SUVmax-M, and EBV DNA were 17.0, 12.7, and 6.9, and 13,800 copies/mL respectively, which were determined by receiver operating characteristic (ROC) curve analysis. Patients with elevated SUVmax-N, SUVmax-M, and EBV DNA levels had a lower 3-year OS rate. In multivariate analysis, the independent prognostic factors of OS included EBV DNA, metastatic site, and locoregional radiotherapy application, while SUVmax was not an independent prognostic factor. Conclusion In de novo metastatic NPC patients, higher SUVmax-N and SUVmax-M were associated with worse prognosis. However, the predictive ability of SUVmax-N and SUVmax-M was poorer than that of EBV DNA.

Frequent monitoring of Epstein-Barr virus DNA load in unfractionated whole blood is essential for early detection of posttransplant lymphoproliferative disease in high-risk patients

Blood ◽  
2001 ◽  
Vol 97 (5) ◽  
pp. 1165-1171 ◽  
Author(s):  
Servi J. C. Stevens ◽  
Erik A. M. Verschuuren ◽  
Inge Pronk ◽  
Wim van der Bij ◽  
Martin C. Harmsen ◽  
...  
Keyword(s):  
Whole Blood ◽  
Epstein Barr Virus ◽  
Lymphoproliferative Disease ◽  
Serum Samples ◽  
Barr Virus ◽  
Load Monitoring ◽  
Risk Patients ◽  
Posttransplant Lymphoproliferative Disease ◽  
Ebv Dna ◽  
Epstein Barr

Posttransplant lymphoproliferative disease (PTLD) is a frequent and severe Epstein-Barr virus (EBV)–associated complication in transplantation recipients that is caused by iatrogenic suppression of T-cell function. The diagnostic value of weekly EBV DNA load monitoring was investigated in prospectively collected unfractionated whole blood and serum samples of lung transplantation (LTx) recipients with and without PTLD. In PTLD patients, 78% of tested whole blood samples were above the cut-off value of quantitative competitive polymerase chain reaction (Q-PCR) (greater than 2000 EBV DNA copies per mL blood), with the majority of patients having high viral loads before and at PTLD diagnosis. Especially in a primary EBV-infected patient and in patients with conversion of immunosuppressive treatment, rapid increases in peripheral blood EBV DNA load diagnosed and predicted PTLD. In non-PTLD transplantation recipients, only 3.4% of the whole blood samples was above the cut-off value (P &lt; .0001) despite heavy immune suppression and cytomegalovirus (CMV)-related disease. These findings illustrate the clinical importance of frequent EBV DNA load monitoring in LTx recipients. The increased EBV DNA loads in PTLD patients were restricted to the cellular blood compartment, as parallel serum samples were all below cut-off value, which indicates absence of lytic viral replication. EBV+ cells in PTLD patients have a very short doubling time, which can be as low as 56 hours, thereby creating the need for high screening frequency in high-risk patients. Furthermore, it is shown that EBV and CMV can reactivate independently in LTx recipients and that EBV DNA load monitoring may be useful in discriminating PTLD from rejection.

Is there a correlation between serum Epstein-Barr virus DNA level and tumor metabolic activity, TNM staging and tumor load in nasopharyngeal cancer patients?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17543-e17543 ◽  
Author(s):  
Aysel Ahmedova ◽  
Kubra Ozkaya ◽  
Makbule Tambas ◽  
Ugur Gezer ◽  
Emre Ozgur ◽  
...  
Keyword(s):  
Copy Number ◽  
Epstein Barr Virus ◽  
Tumor Volume ◽  
Nasopharyngeal Cancer ◽  
Significant Relation ◽  
Dna Copy Number ◽  
Barr Virus ◽  
Pet Ct ◽  
Ebv Dna ◽  
Epstein Barr

e17543 Background: To investigate the relationship between pretreatment Epstein-Barr virus (EBV) DNA copy number and tumor metabolic activity, TNM stage and tumor volume in nasopharyngeal cancer (NPC) patients. Methods: Blood samples were collected 0-3 weeks before treatment and number of EBV DNA copies were determined by PCR . MRI and PET-CT were performed 0-4 weeks before treatment. The primary tumor volume (TVnp) and total volume of metastatic lymph nodes (TLV) were delineated separately on MRI by the same radiologist by the aid of program “Osirix” and recorded in cm3. Maximum SUV values of primary tumor (Tsuv) and metastatic lymph nodes (LNsuv) were determined with each PET-CT images. Kruskal Wallis test and Spearman's Correlation Analysis were used for the comparison of 3 or more groups with no normal distribution and the evaluation of the inter-parameter relations, respectively. Results: The study included 50 NPC patients treated between 2011 and 2015. There was no significant relation between serum EBV DNA copy number and the distribution of T stage (p = 0.81), N stage (p = 0.08), TVnp (r:0.009; p = 0.95), and Tsuv (r:-0.007, p = 0.96). However, a significant correlation was detected between EBV DNA copy number and both LNsuv (r:0.337; p = 0.017) and TLV (r:0.579; p = 0.001) (LNsuv and TLV increased as virus load increased). Conclusions: There is no significant relation between pretreatment EBV DNA load and T and N stages and TVnp in NPC patients. However, EBV DNA load has a significant correlation with TLV and LNsuv. These results may imply that TLV can be included in nodal staging and together with LNsuv be integrated in treatment planning.[Table: see text] [Table: see text]

scholarly journals Epstein-Barr virus DNA is abundant and monoclonal in the Reed-Sternberg cells of Hodgkin's disease: association with mixed cellularity subtype and Hispanic American ethnicity

Blood ◽  
1994 ◽  
Vol 83 (6) ◽  
pp. 1595-1602 ◽  
Author(s):  
ML Gulley ◽  
PA Eagan ◽  
L Quintanilla-Martinez ◽  
AL Picado ◽  
BN Smir ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Odds Ratio ◽  
Epstein Barr Virus ◽  
Hodgkin’S Disease ◽  
Viral Dna ◽  
Mixed Cellularity ◽  
Hispanic Ethnicity ◽  
Barr Virus ◽  
Ebv Dna ◽  
Epstein Barr

One hundred twenty-five cases of Hodgkin's disease from the United States (79), Mexico City (31), and Costa Rica (15) were analyzed for the presence of Epstein-Barr virus (EBV) by in situ hybridization to EBER1 transcripts. EBV was more frequently detected in the Reed- Sternberg (RS) cells of mixed cellularity Hodgkin's disease (37 of 48 [77%]) compared with the nodular sclerosis subtype (19 of 71 [27%], P < .001). The presence of EBV was also associated with Hispanic ethnicity (P < .001). In a multivariate analysis, patient age, gender, and geographic location were less predictive of EBV positivity than were mixed cellularity histology (odds ratio = 8.3) and Hispanic ethnicity (odds ratio = 4.3). Southern blot analysis of EBV terminal repeat fragments using the Xho1a probe showed that the viral DNA was monoclonal in 17 of 17 cases having EBER1-positive RS cells. By comparison, EBV DNA was not detected by Southern analysis in 20 cases lacking EBER1 in RS cells, even when occasional background lymphocytes expressed EBER1. Because clonal viral DNA was so readily detected in EBER1-positive cases, the EBV genome is probably amplified at least 50- fold in the infected RS cells. Monoclonality of EBV DNA implies that the RS cells were infected before malignant transformation.

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