Evaluation of Epstein-Barr Virus Serologic Analysis in North American Patients with Nasopharyngeal Carcinoma and in Comparison Groups

Summary

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.

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