PT  - JOURNAL ARTICLE
AU  - He, Yongqiao
AU  - Yang, Dawei
AU  - Zhou, Ting
AU  - Xue, Wenqiong
AU  - Zhang, Jiangbo
AU  - Li, Fangfang
AU  - Wang, Fang
AU  - Wang, Tongmin
AU  - Wu, Ziyi
AU  - Liao, Ying
AU  - Zheng, Meiqi
AU  - Deng, Changmi
AU  - Li, Danhua
AU  - Jia, Yijing
AU  - Yuan, Leilei
AU  - Zhang, Wenli
AU  - Jia, Weihua
TI  - Epstein-Barr virus DNA loads in the peripheral blood cells predict the survival of locoregionally-advanced nasopharyngeal carcinoma patients
AID  - 10.20892/j.issn.2095-3941.2020.0464
DP  - 2021 Aug 01
TA  - Cancer Biology and Medicine
PG  - 888--899
VI  - 18
IP  - 3
4099  - http://www.cancerbiomed.org/content/18/3/888.short
4100  - http://www.cancerbiomed.org/content/18/3/888.full
SO  - Cancer Biol Med2021 Aug 01; 18
AB  - Objective: Circulating cell-free Epstein-Barr virus (EBV) DNA has been shown to be a valuable biomarker for population screening and prognostic surveillance for nasopharyngeal carcinoma (NPC). Despite important insights into the biology of persistence, few studies have addressed the clinical significance of cell-based EBV-DNA loads in peripheral blood cells (PBCs).Methods: A prospective observational cohort study was conducted involving 1,063 newly diagnosed, locoregionally-advanced NPC patients at Sun Yat-sen University Cancer Center from 2005 to 2007. Cox regression analysis was conducted to identify the association of PBC EBV DNA loads to overall survival (OS) and other prognostic outcomes. Prognostic nomograms were developed based on PBC EBV DNA loads to predict survival outcomes for NPC patients.Results: After a median follow-up of 108 months, patients with higher PBC EBV-DNA loads had significantly worse OS [hazard ratio (HR) of medium, medium-high, and high vs. low were 1.50, 1.52, and 1.85 respectively; Ptrend < 0.001]. Similar results were found for progression-free survival and distant metastasis-free survival. The concordance index of the prognostic nomogram for predicting OS in the training set and validation set were 0.70 and 0.66, respectively. Our data showed that the PBC EBV DNA load was an independent and robust survival biomarker, which remained significant even after adjusting for plasma EBV DNA loads in a subset of 205 patients of the cohort (HR: 1.88; P = 0.025). Importantly, a combination of PBC EBV DNA load and plasma EBV DNA load improved the predicted OS.Conclusions: The EBV-DNA load in PBCs may be an independent prognosis marker for NPC patients.