Evaluation of Epstein-Barr Virus Serologic Analysis in North American Patients with Nasopharyngeal Carcinoma and in Comparison Groups
This prospective cooperative study was initiated in 1978 to determine the value of serologic tests related to Epstein-Barr virus (EBV), including the antibody response to the EBV membrane antigen as measured by the antibody-dependent cellular cytotoxicity (ADCC) assay, in North American patients with different histopathologic types of nasopharyngeal carcinoma (NPC). Serologic testing is a useful diagnostic aid for patients with NPC, particularly those in whom the tumors are small and submucosal (difficult to see or occult). A large body of clinical evidence, histopathologic data, and more recently immunologic studies supports the concept that carcinomas of the nasopharynx constitute two distinct diseases. Today, these are classified as WHO type 1 tumors and combined WHO types 2 and 3 tumors. The ADCC titers obtained at diagnosis often predict the clinical course of patients with WHO types 2 and 3 NPC regardless of the stage of the disease. A low ADCC titer at diagnosis portends a poor prognosis, and the determination of antibody titers identifies patients in whom recurrent disease is likely to develop after conventional irradiation therapy.
This prospective cooperative study was initiated in 1978 to determine the value of serologic tests related to Epstein-Barr virus (EBV), including the antibody response to the EBV membrane antigen as measured by the antibody- dependent cellular cytotoxicity (ADCC) assay, in North American patients with different histopathologic types of nasopharyngeal carcinoma (NPC). It involves several institutions in the United States to provide a sufficient number of patients—mostly Caucasians—from different geographic locations and diverse ethnic backgrounds (Neel et al., 1980, 1981A, 1983, 1984, in press; Pearson et al., 1983). Other studies, primarily in Chinese patients, have found potential value for most of the antibody responses (Henle and Henle, 1966, 1976; Henle et al., 1970, 1971, 1977; Pearson et al., 1971; Ho et al., 1978; Naegele et al., 1982; Sundar et al., 1982; Ringborg et al., 1983).
This report explores the data on the NPC patients and on controls consisting of normal blood donors, patients with squamous cell carcinoma elsewhere in the head and neck, and patients with benign diseases commonly seen in an otorhinolaryngologic practice.
KeywordsSquamous Cell Carcinoma Chronic Lymphocytic Leukemia Nasopharyngeal Carcinoma Actuarial Survival Histopathologic Type
Unable to display preview. Download preview PDF.
- American Joint Committee for Cancer Staging and End-Results Reporting: Manual for Staging of Cancer 1977. Published by the American Joint Committee, 55 East Erie Street, Chicago, IL 60611 (1977).Google Scholar
- Bertram, G., Pearson, G.R., Faggioni, A., Krueger, G.R.F., Sesterhenn, K., Ablashi, D.V., and Levine, P.H., A long-term study of EBV and non-EBV related tests and their correlation with the clinical course of nasopharyngeal carcinoma. In: U. Prasad, D.V. Ablashi, P.H. Levine, and G.R. Pearson (ed.), Proceedings of the Fourth International Symposium on Nasopharyngeal Carcinoma, pp. 115–124, University of Malaya Press, Kuala Lumpur (1983).Google Scholar
- Ho, J.H.C., Stage classification of nasopharyngeal carcinoma: a review. In: G. de-Thé and Y. Ito (ed.), Nasopharyngeal Carcinoma: Etiology and Control, pp. 99–113, International Agency for Research on Cancer, Lyon, France (1978).Google Scholar
- Neel, H.B., III, Pearson, G.R., and Taylor, W.F., Antibody- dependent cellular cytotoxicity: relation to stage and disease course in North American patients with nasopharyngeal carcinoma. Arch. Otolaryngol, (in press).Google Scholar
- Neel, H.B., III, Pearson, G.R., Weiland, L.H., Taylor, W.F., and Goepfert, H.H., Immunologic detection of occult primary cancer of the head and neck. Otolaryngol. Head Neck Surg., 89, 230–234 (1981A).Google Scholar
- Neel, H.B., III, Pearson, G.R., Weiland, L.H., Taylor, W.F., Goepfert, H.H., Pilch, B.Z., Goodman, M., Lanier, A.P., Huang, A.T., Hyams, V.J., Levine, P.H., Henle, G., and Henle W., Application of Epstein-Barr virus serology to the diagnosis and staging of North American patients with nasopharyngeal carcinoma. Otolaryngol. Head Neck Surg., 91, 255–262 (1983).PubMedGoogle Scholar
- Neel, H.B., III, Taylor, W.F., Pearson, G.R., and Weiland, L.H., Clinical staging of patients with nasopharyngeal carcinoma. In: E. Grundmann, G. Krueger, and D. Ablashi (ed.), Cancer Campaign, Vol. 5, pp. 73–79, Gustav Fischer Verlag, Stuttgart (1981B).Google Scholar
- Pearson, G.R., Weiland, L.H., Neel, H.B., III, Taylor, W., Earle, J., Mulroney, S.E., Goepfert, H., Lanier, A., Talvot, M.L., Pilch, B., Goodman, M., Huang, A., Levine, P.H., Hyams, V., Moran, E., Henle, G., and Henle, W., Application of Epstein-Barr virus (EBV) serology to the diagnosis of North American nasopharyngeal carcinoma. Cancer, 51, 260–268 (1983).PubMedCrossRefGoogle Scholar
- Shanmugaratnam, K. and Sobin, L., Histological Typing of Upper Respiratory Tract Tumours. No. 19, World Health Organization, Geneva, Switzerland, pp. 32–33 (1978).Google Scholar
- Sundar, S.K., Ablashi, D.V., Kamaraju, L.S., Levine, P.H., Faggioni, A., Armstrong, G.R., Pearson, G.R., Krueger, G.R., Hewetson, J.F., Bertram, G., Sesterhenn, and Menezes, J., Sera from patients with undifferentiated nasopharyngeal carcinoma contain a factor which abrogates specific Epstein-Barr virus antigen-induced lymphocyte response. Int. J. Cancer, 29, 407–412 (1982).PubMedCrossRefGoogle Scholar