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. 2024 Mar 14;19(1):8.
doi: 10.1186/s13027-024-00570-x.

Impact of plasma Epstein-Barr virus DNA in posttreatment nasopharyngeal carcinoma patients after SARS-CoV-2 infection

Cheng Lin #  1   2 , Meifang Li #  3 , Yingying Lin  1 , Yu Zhang  1 , Hanchuan Xu  1 , Bijuan Chen  1 , Xia Yan  1 , Yun Xu  4
Affiliations

Impact of plasma Epstein-Barr virus DNA in posttreatment nasopharyngeal carcinoma patients after SARS-CoV-2 infection

Cheng Lin et al. Infect Agent Cancer. .

Abstract

Background: Nasopharyngeal carcinoma (NPC) is prevalent in southern China. EBV DNA is the most useful biomarker in NPC. However, the value of EBV DNA in posttreatment NPC patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear.

Methods: Sixty-four eligible NPC patients were enrolled between December 2022 and February 2023. Patients who met the following criteria were included: had non-metastatic NPC, completed radical treatment, were first firstly infected with SARS-CoV-2 and their EBV DNA changed from undetectable to detectable.

Results: At the end of follow-up, 81.25% (52/64) of patients were confirmed not to relapse with undetectable EBV DNA (no-relapse). In addition, 18.75% (12/64) of patients experienced relapse with consistent detection of EBV DNA (yes-relapse). For all 64 patients, the average time from diagnosis of coronavirus disease 2019 (COVID-19) to detection of detectable EBV DNA was 35.41 days (2 to 139 days). For 52 no-relapse patients, the average time from EBV DNA changing from detectable to undetectable was 63.12 days (6 to 147 days). The levels of EBV DNA were greater in yes-relapse patients than that in no-relapse patients, and the average of EBV DNA levels were 1216 copies/ml and 53.18 copies/ml, respectively. Using 62.3 copies/mL as the threshold, the area under the curve for EBV DNA was 0.88 for distinguishing yes-relapse patients from no-relapse patients. The sensitivity and specificity were 81.97% (95% CI 0.71-0.95) and 86.67% (95% CI 0.70-0.95), respectively.

Conclusion: For NPC patients infected with SARS-CoV-2, EBV DNA alone is insufficient for monitoring relapse after radical therapy. Long-term follow-up and underlying mechanistic investigations of EBV DNA changes are urgently needed.

Keywords: COVID-19; EBV DNA; Nasopharyngeal carcinoma; Omicron; Relapse.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the patient selection process
Fig. 2
Fig. 2
EBV DNA changes in NPC patients infected with SARS-CoV-2. A Changes in EBV-DNA concentrations in patients who did not relapse with undetectable EBV DNA (no-relapse) and in patients who experienced relapse with consistently detectable EBV DNA (yes-relapse). B Typical case of EBV DNA changes in one yes-relapse patient and one no-relapse patient who underwent timely follow-up and examination
Fig. 3
Fig. 3
Receiver operating characteristic (ROC) curve analysis of EBV DNA for the diagnosis of relapse
See this image and copyright information in PMC

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