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Prevalence and relevance of EBV latency in nasopharyngeal carcinoma in Israel

¹ Department of Oncology, Rambam Medical Centre and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel
² Department of Pathology, Rambam Medical Centre and Faculty of Medicine
³ Department of Otolaryngology, Rambam Medical Centre and Faculty of Medicine

Correspondence to:
Dr G Bar-Sela
Department of Oncology, Rambam Medical Centre, PO Box 9602, Haifa 31096 Israel; g\|[lowbar]\|barsela{at}rambam.health.gov.il Background: Nasopharyngeal carcinoma (NPC) is frequently associated with Epstein-Barr virus (EBV). The incidence of NPC in Western countries is lower than in the Far East, and EBV latency in NPC is less prevalent. Israel, as a part of the Mediterranean area, is one of the countries with an intermediate risk for NPC.

Methods: Immunohistochemistry (IHC) for latent membrane protein 1 (LMP-1) and in situ hybridisation (ISH) for EBV encoded RNA (EBER) were used to evaluate the prevalence and possible prognostic value of EBV latency among Israeli patients with NPC. Forty five patients with different NPC histologies were studied.

Results: LMP-1 IHC was positive in six samples only, all with undifferentiated histology. EBER ISH was positive in 40 of the 45 samples. According to histological type, three of five patients with squamous cell carcinoma were EBV positive and 37 of 40 non-keratinising and undifferentiated carcinoma cases were positive. Although EBV was more prevalent in patients with non-squamous carcinoma, the difference was not significant, probably because of the small number of patients with keratinising carcinoma. With regard to the clinical categories and survival, no significant difference could be detected between patients who were positive or negative for EBER ISH. No association was found between EBV latency and patient sex, age, origin, stage, or survival.

Conclusions: NPC in Israel is highly associated with EBV latency as detected by EBER ISH. LMP-1 IHC is considerably less sensitive in detecting EBV latency in NPC among the same patient group.

Keywords: Epstein-Barr virus; nuclear Epstein-Barr virus encoded RNA in situ hybridisation; nasopharyngeal carcinoma

Abbreviations: AJCC, American Joint Committee of Cancer; EBER, nuclear Epstein-Barr virus encoded RNA; EBV, Epstein-Barr virus; IHC, immunohistochemistry; ISH, in situ hybridisation; LMP-1, latent membrane protein 1; NPC, nasopharyngeal carcinoma; WHO, World Health Organisation

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