Prognostic implication of pretreatment titer of serum immunoglobulin A against Epstein-Barr virus capsid antigen in nasopharyngeal carcinoma patients in Sihui, Guangdong.

BACKGROUND AND OBJECTIVE: Currently, the serum immunoglobulin A against Epstein-Barr virus capsid antigen (EBV-VCA/IgA) is one of the most commonly used markers for diagnosis of nasopharyngeal carcinoma (NPC). However, its value for prognostic implication in NPC patients is unclear. This study was to evaluate the relationship between pretreatment titers of EBV-VCA/IgA and NPC patients' survival.

METHODS: The clinicopathologic data of 317 NPC patients treated in Sun Yat-sen University Cancer Center between 1990 and 2003 were retrieved from the registration system of cancer incidence and mortality of Sihui city, Guangdong province. The correlation of pretreatment EBV-VCA/IgA titers to the survival of these patients was analyzed.

RESULTS: Pretreatment VCA/IgA titer was significantly higher in stage III-IV NPC patients than in stage I-II patients (p = 0.01). The survival time was significantly shorter in the 170 patients with higher EBV-VCA/IgA titers (>or= 1:160) than in the 147 patients with lower EBV-VCA/IgA titers ( < 1:160). The 5-year survival rate was 65% in low EBV-VCA/IgA titer group and 43% in high titer group (p = 0.01). Multivariate analyses showed that clinical stage, sex, the year of treatment, and pretreatment serum EBV-VCA/IgA titer were all independent prognostic factors of NPC.

CONCLUSION: Pretreatment serum EBV-VCA/IgA titer may be used as an independent prognostic marker of NPC.