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European Archives of Oto-Rhino-Laryngology

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01-09-2020 | Magnetic Resonance Imaging | Head and Neck

Lymph-node Epstein–Barr virus concentration in diagnosing cervical lymph-node metastasis in nasopharyngeal carcinoma

Authors: HuiFang Li, Can Huang, Qiuyan Chen, Chuan Peng, Rong Zhang, Jingxian Shen, Mingyuan Chen, Haiqiang Mai, Ruhai Zou

Published in: European Archives of Oto-Rhino-Laryngology | Issue 9/2020

Abstract

Purpose

Cervical lymph-node (CLN) metastasis commonly occurs in patients with nasopharyngeal carcinoma (NPC) metastasis. The presence of Epstein–Barr virus (EBV) genomes in neck lymph nodes may diagnose CLN. This research was designed to appraise the diagnostic value of EBV concentration for cervical lymph nodes in NPC.

Methods

Two hundred and fifty-three NPC patients with 276 CLNs were enrolled. MRI was performed to detect CLN metastasis, and plasma EBV concentration was measured by quantitative PCR before treatment. Ultrasonography (US) and US-FNA were subsequently performed in the suspicious lymph nodes. Fifteen patients (22 lymph nodes) underwent fine-needle aspiration cytology (FNAC), and the remaining 242 patients (254 lymph nodes) underwent core needle biopsy (CNB) for CLNs at the clinician’s demand. The aspiration needle was rinsed with 1 ml of normal saline for EBV detection. The method of lymph-node EBV measurement was consistent with that for plasma. The MRI results and EBV concentrations in plasma and lymph nodes were recorded and analyzed. Plasma EBV concentrations ≥ 4000 copies/ml were regarded as positive.

Results

CLN-EBV concentrations ≥ 787.5 copies/ml were regarded as positive according to receiver-operating characteristic curve analysis. The AUC of the EBV (0.925) concentration in CLN metastasis was significantly larger than the AUC of MRI (0.714) (P < 0.001). The sensitivity and specificity were 94.09% and 48.72% for MRI in lymph-node metastasis and 95.36% (P > 0.05) and 84.62% (P < 0.01) for EBV DNA in CLN metastasis, respectively. The sensitivity and specificity of EBV in plasma were 77.2% and 71.8%, respectively. The diagnostic specificity and AUC of EBV in CLNs were higher than those of MRI and plasma EBV (P < 0.005).

Conclusions

Ultrasound-guided CLN FNA to obtain EBV concentrations may provide a new method to diagnose CLN metastasis with high sensitivity and specificity.

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Title: Lymph-node Epstein–Barr virus concentration in diagnosing cervical lymph-node metastasis in nasopharyngeal carcinoma
Authors: HuiFang Li
Can Huang
Qiuyan Chen
Chuan Peng
Rong Zhang
Jingxian Shen
Mingyuan Chen
Haiqiang Mai
Ruhai Zou
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Ultrasound
Magnetic Resonance Imaging
Metastasis
Epstein-Barr Virus
Foreign Body Aspiration
Foreign Body Aspiration
Aspiration
Ultrasound
Published in: European Archives of Oto-Rhino-Laryngology / Issue 9/2020
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-05937-5

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Springer Medicine

Lymph-node Epstein–Barr virus concentration in diagnosing cervical lymph-node metastasis in nasopharyngeal carcinoma

Abstract

Purpose

Methods

Results

Conclusions

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Abstract

Purpose

Methods

Results

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