Abstract：
BACKGROUND: Nasopharyngeal carcinoma (NPC), arising from nasopharyngeal epithelium is caused by Epstein-Barr virus (EBV). It is common in South China, South East Asia and North East India. The aim and objectives of this study were to determine the prevalence of EBV in formalin-fixed paraffin-embedded (FFPE) tissue sections of clinically suspected NPC patients, correlate the results of polymerase chain reaction (PCR) with histopathology findings, and to determine the utility of tissue EBV DNA as a diagnostic bio-marker.
METHODS: 31 FFPE tissue samples were collected from clinically suspected NPC patients from April 2018-December 2019. Histopathological diagnosis was done by examination of Hematoxylin and Eosin stained slides. Presence of EBV was detected by EBNA-1 PCR. IHC was performed using EBV Latent Membrane Protein 1.
RESULTS: Of the 31 clinically suspected NPC cases, 15 (48.4 %) were histopathological confirmed NPC. Of these15, 13 (86.6 %) were non-keratinising undifferentiated NPC, and one each were keratinising NPC and non-keratinising differentiated NPC respectively. EBV EBNA1 PCR was positive in 35.5 % (11/31) of clinically suspected NPC cases. Of the 11 PCR positive cases, 9 (81.8 %) were histopathological confirmed NPC. Of the 31 clinically suspected NPC cases, IHC was indicated in 23 biopsies. Of which, 12 (52.2 %) were positive for LMP1 in the abnormal cells. Of the 12 IHC positive samples, 10 were NPC cases.
CONCLUSIONS: EBV DNA as an indicator towards NPC among clinically suspected cases had a sensitivity of 60 % and specificity of 87.5 %. In this study, addition of EBV DNA detection by PCR from FFPE tissue sections could confirm EBV association in 20 % of cases where it was not detected by EBV LMP1 IHC, thus helped in increasing the detection of EBV positivity in NPC cases. Early diagnosis of NPC will improve the cure rate and hence reduce the morbidity and mortality rates.
METHODS: 31 FFPE tissue samples were collected from clinically suspected NPC patients from April 2018-December 2019. Histopathological diagnosis was done by examination of Hematoxylin and Eosin stained slides. Presence of EBV was detected by EBNA-1 PCR. IHC was performed using EBV Latent Membrane Protein 1.
RESULTS: Of the 31 clinically suspected NPC cases, 15 (48.4 %) were histopathological confirmed NPC. Of these15, 13 (86.6 %) were non-keratinising undifferentiated NPC, and one each were keratinising NPC and non-keratinising differentiated NPC respectively. EBV EBNA1 PCR was positive in 35.5 % (11/31) of clinically suspected NPC cases. Of the 11 PCR positive cases, 9 (81.8 %) were histopathological confirmed NPC. Of the 31 clinically suspected NPC cases, IHC was indicated in 23 biopsies. Of which, 12 (52.2 %) were positive for LMP1 in the abnormal cells. Of the 12 IHC positive samples, 10 were NPC cases.
CONCLUSIONS: EBV DNA as an indicator towards NPC among clinically suspected cases had a sensitivity of 60 % and specificity of 87.5 %. In this study, addition of EBV DNA detection by PCR from FFPE tissue sections could confirm EBV association in 20 % of cases where it was not detected by EBV LMP1 IHC, thus helped in increasing the detection of EBV positivity in NPC cases. Early diagnosis of NPC will improve the cure rate and hence reduce the morbidity and mortality rates.
摘要：
背景：鼻咽癌（NPC），由鼻咽上皮引起的是由EB病毒（EBV）引起的。这在中国南方很常见，东南亚和印度东北部。这项研究的目的和目标是确定临床可疑NPC患者的福尔马林固定石蜡包埋（FFPE）组织切片中EBV的患病率，将聚合酶链反应（PCR）的结果与组织病理学结果相关联，并确定组织EBVDNA作为诊断生物标记的实用性。
方法：从2018年4月至2019年12月的临床可疑NPC患者中收集31份FFPE组织样本。通过检查苏木精和伊红染色的载玻片进行组织病理学诊断。通过EBNA-1PCR检测EBV的存在。使用EBV潜在膜蛋白1进行IHC。
结果：在31例临床可疑的NPC病例中，15例（48.4％）为组织病理学证实的NPC。其中15个，13个（86.6%）为非角化未分化NPC，分别为角化NPC和非角化分化NPC。在35.5％（11/31）的临床可疑NPC病例中，EBVEBNA1PCR阳性。在11例PCR阳性病例中，9例（81.8%）为病理证实的NPC。31例临床疑似病例中,23例活检显示IHC。其中，12例(52.2%)异常细胞中LMP1阳性。在12个IHC阳性样本中，10例NPC病例。
结论：EBVDNA作为临床疑似病例中NPC的指标的敏感性为60%，特异性为87.5%。在这项研究中,通过PCR从FFPE组织切片中添加EBVDNA检测可以证实EBV关联在20%的病例中未被EBVLMP1IHC检测到，因此，有助于增加NPC病例中EBV阳性的检测。NPC的早期诊断将提高治愈率，从而降低发病率和死亡率。
方法：从2018年4月至2019年12月的临床可疑NPC患者中收集31份FFPE组织样本。通过检查苏木精和伊红染色的载玻片进行组织病理学诊断。通过EBNA-1PCR检测EBV的存在。使用EBV潜在膜蛋白1进行IHC。
结果：在31例临床可疑的NPC病例中，15例（48.4％）为组织病理学证实的NPC。其中15个，13个（86.6%）为非角化未分化NPC，分别为角化NPC和非角化分化NPC。在35.5％（11/31）的临床可疑NPC病例中，EBVEBNA1PCR阳性。在11例PCR阳性病例中，9例（81.8%）为病理证实的NPC。31例临床疑似病例中,23例活检显示IHC。其中，12例(52.2%)异常细胞中LMP1阳性。在12个IHC阳性样本中，10例NPC病例。
结论：EBVDNA作为临床疑似病例中NPC的指标的敏感性为60%，特异性为87.5%。在这项研究中,通过PCR从FFPE组织切片中添加EBVDNA检测可以证实EBV关联在20%的病例中未被EBVLMP1IHC检测到，因此，有助于增加NPC病例中EBV阳性的检测。NPC的早期诊断将提高治愈率，从而降低发病率和死亡率。
