Antibodies to Epstein-Barr Virus in Nasopharyngeal Carcinoma, Other Head and Neck Neoplasms, and Control Groups2

Abstract

Sera collected in East Africa, Hong Kong, India, and France from patients with head and neck neoplasms, patients with nonneoplastic disease, and donors in apparently good health were titrated for antibodies to the Epstein-Barr virus (EBV) by the indirect immunofluorescence technique. The results were correlated with the clinical and histological diagnoses which, as a rule, became available only after performance of the tests. Of 235 East African and Chinese patients who were classified as cases of nasopharyngeal carcinoma (NPC), 84% had high anti-EBV liters (≧ 1:160) and the geometric mean level was 1:348. The histopathology, whether described as anaplastic carcinoma or not, poorly or moderately well-differentiated, squamous or epidermoid carcinoma, seemed irrelevant. When the NPC patients from Hong Kong were grouped according to the stage of their disease, the incidence of high anti-EBV titers increased successively from 45% in stage I to ultimately 100% in stage V. The geometric mean titers rose correspondingly from 1:103 in the initial to 1:788 in the final stages. In contrast, patients with neoplasms (mainly carcinomas) arising in sites of the head and neck other than the nasopharnyx revealed a sixfold lower incidence of high titers (13%) and a nearly tenfold lower geometric mean level (1:36). Assortment of these patients as to the sites and types of their neoplasms revealed no significant differences in the distribution of anti-EBV levels among the groups so obtained. The incidence of high tilers and the geometric mean level among controls resembled those in patients with neoplasms other than NPC. The significance and implications of these findings are discussed.