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Clinical and Vaccine Immunology, April 2007, p. 435-441, Vol. 14, No. 4
1071-412X/07/$08.00+0 doi:10.1128/CVI.00466-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
Serum Antibody Response to Lytic and Latent Epstein-Barr Virus Antigens in Undifferentiated Nasopharyngeal Carcinoma Patients from an Area of Nonendemicity
Rosamaria Tedeschi,1*
Elisa Pin,1
Debora Martorelli,2
Ettore Bidoli,3
Alessia Marus,1
Chiara Pratesi,1
Maria Teresa Bortolin,1
Stefania Zanussi,1
Emanuela Vaccher,4
Riccardo Dolcetti,2 and
Paolo De Paoli1
Microbiology-Immunology and Virology Unit,1 Immunovirology and Biotherapy Unit,2 Epidemiology Unit,3 Medical Oncology Department, Centro di Riferimento Oncologico, Istituto di Recovero e Cura a Carattere Scientifico, Aviano, Italy4
Received 11 December 2006/ Returned for modification 27 January 2007/ Accepted 13 February 2007
Epstein-Barr virus (EBV)-associated undifferentiated carcinoma of the nasopharyngeal type (UCNT) is highly prevalent in southeast China, where immunoglobulin A (IgA) antibodies to viral capsid antigen and early antigen (EA) represent important markers, routinely used to assist in diagnosing this malignancy. Our study aimed at determining the EBV serological profiles of 78 UCNT patients from Italy, an area of nonendemicity for this tumor, using different assays specific for both lytic and latent EBV antigens. Serum IgA against both EA and EBNA1 and IgG and IgA to the latent membrane protein 1 (LMP1), to EA, and to the EBV transactivator ZEBRA protein were assessed. These serological responses were then evaluated according to the clinicopathologic parameters at diagnosis. The sensitivities of the IgG assays were 37.7% for LMP1, 73.6% for EA, and 61.0% for ZEBRA. EA/EBNA1 IgA reactivity was 84.4%, and a high association (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.7 to 4.0) with UCNT was observed. When EBV serological reactivities were analyzed according to the tumor, node, and metastasis staging system (TNM), a statistically significant association was found between N stage and IgG antibody rates for EA (OR, 3.6; 95% CI, 1.2 to 10.9) and ZEBRA (OR, 2.6; 95% CI, 1.2 to 5.5) and between M stage and IgG antibody rates for ZEBRA (OR, 7.1; 95% CI, 3.2 to 16.0) and LMP1 (OR, 14.0; 95% CI, 1.8 to 110.9). Our results show that no single serological marker allows the detection of all UCNT cases. EA/EBNA1 IgA represents a reliable marker for diagnosis, with a high predictive value also in areas where UCNT is not endemic, such as Italy. The analysis of serological results according to TNM classification is consistent with a progressive impairment of humoral immune response to EBV as the disease advances and may be used to improve the accuracy of diagnosis.
* Corresponding author. Mailing address: Microbiology-Immunology and Virology Unit; Centro di Riferimento Oncologico, Istituto di Recovero e Cura a Carattere Scientifico, Aviano, Italy. Phone: 39(0)434-659421. Fax: 39(0)434-659402. E-mail: rtedeschi{at}cro.it
Published ahead of print on 28 February 2007.
Clinical and Vaccine Immunology, April 2007, p. 435-441, Vol. 14, No. 4
1071-412X/07/$08.00+0 doi:10.1128/CVI.00466-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
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