ВИРУС ЭПШТЕЙНА-БАРР И РАК НОСОГЛОТКИ: ВИРУСНЫЕ МАРКЁРЫ ДЛЯ ДИАГНОСТИКИ И ОЦЕНКИ КЛИНИЧЕСКОГО СТАТУСА БОЛЬНЫХ

Статья в Elpub

Вопросы вирусологии. 2018; 63: 77-84

ВИРУС ЭПШТЕЙНА-БАРР И РАК НОСОГЛОТКИ: ВИРУСНЫЕ МАРКЁРЫ ДЛЯ ДИАГНОСТИКИ И ОЦЕНКИ КЛИНИЧЕСКОГО СТАТУСА БОЛЬНЫХ

Кондратова В. Н., Ломая М. В., Игнатова А. В., Душенькина Т. Е., Смирнова К. В., Мудунов А. М., Лихтенштейн А. В., Гурцевич В. Э., Сенюта Н. Б.

https://doi.org/10.18821/0507-4088-2018-63-2-77-84

Аннотация

Этиологическая роль вируса Эпштейна-Барр (ВЭБ) в возникновении недифференцированного гистологического варианта рака носоглотки (нРНГ) впервые доказана в регионах с высоким уровнем заболеваемости этой патологией, южных провинциях Китая и странах Юго-Восточной Азии, а позже и в остальных странах мира. Высокие титры антител к ВЭБ, сопровождающие нРНГ, позволили широко использовать серологические маркёры вируса для диагностики этой опухоли. В последние годы в эндемичных по нРНГ регионах для раннего выявления и мониторинга болезни большое распространение получило тестирование плазмы крови больных на содержание ДНК ВЭБ. В неэндемичных регионах такие исследования практически не проводились, не изучена и сравнительная оценка диагностической и прогностической значимости вирусных маркеров нРНГ: гуморального ответа к ВЭБ и нагрузки вирусными копиями кровотока больных. Цель данного исследования, проводимого в России, заключалась в сравнении клинической значимости серологических маркёров ВЭБ и вирусной ДНК в плазме крови больных нРНГ из неэндемичного региона. Полученные результаты свидетельствуют о том, что IgA-антитела к вирусному капсидному антигену (IgA/ВКА) и копии ДНК ВЭБ в плазме могут быть с успехом использованы для диагностики нРНГ у больных из этого региона, в то время как IgG/ВКА-антитела в качестве маркёра не имеют практического значения. Кроме того, было обнаружено, что показатель концентрации ДНК ВЭБ в плазме крови больных является более чувствительным маркёром нРНГ, чем титры IgA/ВКА-антител, поскольку он более точно отражает эффект проведённой терапии и клиническое состояние больных в периоды ремиссии или рецидива. Впервые показано, что в неэндемичном регионе наиболее эффективным для диагностики нРНГ является комбинированная оценка уровней анти-ВЭБ IgA/ВКА-антител и концентрации в плазме больных вирусной ДНК.

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Problems of Virology. 2018; 63: 77-84

EPSTEIN-BARR VIRUS AND NASOPHARYNGEAL CARCINOMA: VIRAL MARKERS FOR DIAGNOSTICS AND ASSESSMENT OF CLINICAL STATUS OF PATIENTS

Kondratova V. N., Lomaya M. V., Ignatova A. V., Dushenkina T. E., Smirnova K. V., Mudunov A. M., Lichtenstein A. V., Gurtsevitch V. E., Senyuta N. B.

https://doi.org/10.18821/0507-4088-2018-63-2-77-84

Abstract

The etiological role of the Epstein-Barr virus (EBV) in the development of an undifferentiated histological variant of nasopharyngeal carcinoma (uNPC) found for the first time in regions with a high incidence of this pathology, the Southern provinces of China and the countries of Southeast Asia, and later in the rest of the world, has served as a basis for the widespread use of EBV serological markers for the diagnosis of this form of tumor. In recent years, the use of a test based on the quantitative determination of the EBV DNA concentration in the blood plasma of uNPC patients for early detection and monitoring of the disease has become widespread in endemic regions. In non-endemic regions, such studies virtually have not been carried out, and moreover, the comparative evaluation of the significance of two viral markers, serological and EBV DNA load in the bloodstream of uNPC patients, for diagnostics and evaluation of the therapeutic effect was not investigated. The aim of this study was to compare the clinical value of two serological markers and plasma EBV DNA load in uNPC patients from non-endemic region (Russia). The obtained results indicate that IgA antibodies to the viral capsid antigen (IgA/VCA) and plasma EBV DNA concentration can be successfully used for the diagnosis of uNPC, while IgG/VCA antibodies have no practical significance as an uNPC marker. In addition, it was found that plasma EBV DNA load is more sensitive marker of uNPC than IgA/VCA titers because DNA copy numbers reflect more accurately the effect of the therapy and the clinical state of patients at the stages of remission or relapse. It was shown for the first time that in the non-endemic region the simultaneous evaluation of IgA/VCA antibody levels and the plasma EBV DNA loads are the most effective markers for the diagnostics of uNPC. However, we believe, that it is more practical to use IgA/VCA antibody levels for uNPC screening, and plasma EBV DNA copies - for monitoring of the disease.

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