Clinical implications of hepatitis B viral infection in Epstein–Barr virus-associated nasopharyngeal carcinoma
Section snippets
Background
Oncoviruses contribute to the development of approximately 12% of human cancers and are considered to be an important factor in the activation of malignant cancer, including herpes virus with Kaposi's sarcoma, human papillomavirus with cervical cancer and head and neck cancer, hepatitis B virus (HBV) and hepatitis C virus (HCV) with hepatocellular carcinoma (HCC), human T cell lymphotropic virus-1 with adult T-cell leukemia, and Epstein–Barr virus (EBV) with lymphoma and nasopharyngeal
Objective
We plan to investigate the clinical characteristics and prognostic factors in patients with newly-diagnosed NPC with HBV infection.
Study population
In total, 722 patients with newly pathologically-diagnosed NPC at the First People's Hospital of Foshan between June 2006 and December 2011 were enrolled in this retrospective study. The pre-treatment work-up has previously been described in detail [20], [21]. All patients were routinely screened for hepatitis B at the time of diagnosis using the serologic markers HBsAg, hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (anti-HBe) and hepatitis B
Follow-up, clinical characteristics and virus status
Follow-up protocol was as previously described [20], [21]. The median follow-up time was 51.8 months (range, 1.7–136.5 months). In total, 79 (10.9%) and 643 (89.1%) patients were HBsAg(+) and HBsAg(−), respectively. Histologically, biopsies confirmed that 716 (99.2%) patients had non-keratinizing squamous cell carcinoma. Pre-treatment and post-treatment plasma EBV DNA data was available for 554 (76.7%) and 360 (49.9%) patients, respectively. In the HBsAg(+) cohort (n = 79), pre-treatment HBV DNA
Discussion
Our findings confirm that HBV infection increases the risk for distant recurrence, especially in the liver, and poor survival in patients with EBV-associated NPC. There is no evidence to support an association between HBV status and EBV status in patients with EBV-associated NPC.
Approximately 10–12% of the general population in the endemic area has chronic HBV infection, as indicated by HBsAg seropositivity. The prevalence of HBsAg seropositivity in patients with NPC in this study was 10.9%
Funding
This work was supported by a grant from National Natural Science Foundation of China (81372410, 81071837, 30670627 to YHL), the Natural Science Foundation of Guangdong Province, PR China, (9151008901000223 to HWH) and grants from the National Cancer Institute (R01-CA90853 to FXC), the Sister Institution Network Fund (FXC).
Competing interests
The authors have no commercial or other associations that might pose a conflict of interest.
Ethical approval
The ethical committee of the First People's Hospital of Foshan, Foshan, PR China, approved the study protocol.
Acknowledgements
We thank Ms. Lina Wei and Dr. Jinhuan Cui for support.
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