RT Journal Article SR Electronic T1 Epstein-Barr virus DNA loads in the peripheral blood cells predict the survival of locoregionally-advanced nasopharyngeal carcinoma patients JF Cancer Biology and Medicine JO Cancer Biol Med FD China Anti-Cancer Association SP 888 OP 899 DO 10.20892/j.issn.2095-3941.2020.0464 VO 18 IS 3 A1 Yongqiao He A1 Dawei Yang A1 Ting Zhou A1 Wenqiong Xue A1 Jiangbo Zhang A1 Fangfang Li A1 Fang Wang A1 Tongmin Wang A1 Ziyi Wu A1 Ying Liao A1 Meiqi Zheng A1 Changmi Deng A1 Danhua Li A1 Yijing Jia A1 Leilei Yuan A1 Wenli Zhang A1 Weihua Jia YR 2021 UL http://www.cancerbiomed.org/content/18/3/888.abstract 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.