The association between epstein-barr virus and nasopharyngeal carcinoma

Abstract

Background: Nasopharyngeal carcinoma (NPC) is a rare malignant neoplasm which has a wide age range but affects predominantly adult males. NPC is highly associated with Epstein-Barr virus. There are 3 histological subtypes described by the World Health Organisation (WHO), the commonest being the non-keratinizing subtype. Methods: In this retrospective study, confirmed cases of nasopharyngeal carcinoma were identified over a six and half year period in a South African population. The patient age, gender, HIV status and CD4 cell count were recorded where available. The site and type of biopsy, histological subtypes and EBER-ISH status of the tumour were also noted. Results: There were 120 cases of nasopharyngeal carcinoma during the study period. The age range was 10-75 years. The male to female ratio was 1.8:1. The most frequently biopsied site was the nasopharynx which constituted 74 (60.12%) cases. Of the 120 cases analysed, 110 cases (81.6 %) were classified as non-keratinizing nasopharyngeal carcinoma and there were two cases (1.68%) which were classified as keratinizing nasopharyngeal carcinoma. Eight cases (6.72%) could not be classified into any category. There were no cases of basaloid nasopharyngeal carcinoma in this cohort. EBER-ISH had been performed in 102 cases and 96 (94.1%) were positive. In these 96 cases, 87 (90.6%) cases were of the non-keratinizing subtype of NPC. HIV results were only available in 19 cases with 9 of these cases occurring in HIV positive patients. Of these 19 cases, CD4 cell counts were only available in 3 cases with a range of 300-900 cells/mm3. Conclusion: The study confirms that South African population shows nasopharyngeal carcinoma in a wide age range similar to other parts of the world. The most common histological subtype is non-keratinizing nasopharyngeal carcinoma. Nasopharyngeal carcinoma is strongly associated with Epstein-Barr virus in this population.