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Prognostic value of Epstein–Barr virus DNA level for nasopharyngeal carcinoma: a meta-analysis of 8128 cases

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

Plasma levels of Epstein–Barr virus (EBV) DNA have been employed to predict survival outcomes of patients with nasopharyngeal carcinoma (NPC). However, the prognostic value of subsequent EBV DNA levels (mid or post treatment) for NPC is needed to identify by a large cohort of patients. We performed a meta-analysis of studies including data from 8128 patients to evaluate the prognostic value of EBV DNA in NPC patients.

Methods

We searched PubMed, Web of Science, and the Cochrane library for prospective and retrospective studies. Hazard ratios (HRs) and confidence intervals (CIs) were extracted from the studies or calculated and pooled to assess the association between EBV DNA levels pre-treatment (pre-DNA), mid-treatment (mid-DNA), and post-treatment (post-DNA) on clinical outcomes.

Results

A total of 22 studies with 8128 patients was included for analysis. Pre-DNA levels predicted overall survival, progression-free survival, distant metastasis-free survival, and local–regional failure survival with HRs (95% CIs) of 2.70 (2.06, 3.54), 2.70 (2.12, 3.44), 3.49 (2.35, 5.17), and 2.00 (1.45, 2.76), respectively, and the corresponding HRs for post-DNA levels were 4.86 (3.30, 7.17), 6.29 (3.41, 11.60), 5.68 (2.71,11.93), respectively. Mid-DNA levels predicted overall survival and progression-free survival with an HR (95% CI) of 3.02 (1.54, 5.29) and 3.15 (2.05, 4.83). Subgroup analysis showed that the HR of post-DNA wasn’t influenced by different detection time of post-DNA (P = 0.22, I2 = 33.2%).

Conclusion

The EBV DNA levels have a significant prognostic impact in patients with NPC. The effect of post-treatment EBV DNA level dominated that of pre-DNA and mid-DNA levels.

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Acknowledgements

We thank Anne M. O’Rourke, PhD, from Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This study was supported by the Medical Scientific Research Foundation of Guangdong Province of China (A2018425) and the Science and Technology Innovation Project from Foshan, Guangdong (FS0AA-KJ218-1301-0006).

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Authors and Affiliations

  1. Department of Clinical Laboratory, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, 528300, Guangdong, People’s Republic of China

    Hongling Qu, Yuanqing Zhou & Weibiao Lv

  2. Department of Cardiology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, People’s Republic of China

    Yuli Huang

  3. Department of Radiation Oncology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, People’s Republic of China

    Shufen Zhao

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  1. Hongling Qu
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Correspondence to Weibiao Lv.

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Because our research was a meta analysis, we did not collect any samples of human and animals. No ethical approval or patient consent was needed.

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Qu, H., Huang, Y., Zhao, S. et al. Prognostic value of Epstein–Barr virus DNA level for nasopharyngeal carcinoma: a meta-analysis of 8128 cases. Eur Arch Otorhinolaryngol 277, 9–18 (2020). https://doi.org/10.1007/s00405-019-05699-9

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