The Serological Examination of Immunoglobulin A Anti-Early Antigen of Epstein–Barr Virus (Anti-EA EBV IgA) in the Nias Tribe Nasopharyngeal Cancer Patients

Hana Isal Salina Ginting; Farhat Farhat; Mutiara Indah Sari

doi:10.3889/oamjms.2022.7025

Authors

Hana Isal Salina Ginting Master Program in Tropical Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Farhat Farhat Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Mutiara Indah Sari Department of Biochemistry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.7025

Keywords:

Early antigen, Epstein–Barr virus, Immunoglobulin A, Nasopharyngeal cancer, Serology

Abstract

BACKGROUND: Nasopharyngeal cancer (NPC) is a health problem associated with malignancies of the ear, nose, and throat. The main pathogenesis of NPC is Epstein–Barr virus (EBV) infection. The signs and symptoms of NPC are non-specific, causing the occurrence of delay in diagnosis leading to treatment failure. The early detection based on the NPC profile using immunoglobulin A (IgA) antibodies against the early antigen (EA) can be done, but many factors affect anti-EA EBV IgA levels, one of which is ethnicity.

AIM: This study aimed to compare levels of anti-EA EBV IgA in NPC patients and non-NPC in the Nias tribe.

MATERIALS AND METHODS: This study was cross-sectional involving 29 NPC patients and 29 non-NPC in the Nias tribe. The subjects of the study were blood tests to measure the levels of anti-EA EBV IgA by a serological test. Data were analyzed by Chi-square test.

RESULTS: The results showed that the mean value of anti-EA EBV IgA levels is 246.22 ± 320.05 U/mL and the proportion of positive serology tests is 55.2% in NPC patients. The mean value of anti-EA EBV IgA levels is 51.79 ± 1.55 U/mL and the proportion of positive serology tests is 10.3% in non-NPC. The comparison of mean anti-EA EBV IgA between NPC patients and non-NPC was significant (p < 0.001). The comparison of positive and negative serology tests of anti-EA EBV IgA between NPC patients and non-NPC was significant (p < 0.05).

CONCLUSION: The serology tests of anti-EA EBV IgA play a role in differentiating NPC patients from non-NPC, so it can be useful as a screening tool for NPC in the Nias tribe.

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References

Kementrian Kesehatan Republik Indonesia. Panduan Penatalaksanaan Kanker Nasofaring Kementerian Kesehatan Komite Penanggulangan Kanker Nasional. Indonesia: Kementrian Kesehatan Republik Indonesia; 2019.

Adham M, Kurniawan AN, Muhtadi AI, Roezin A, Hermani B, Gondhowiardjo S, et al. Nasopharyngeal carcinoma in Indonesia: Epidemiology, incidence, signs, and symptoms at presentation. Chin J Cancer. 2012;31(4):185-96. https://doi.org/10.5732/cjc.011.10328 PMid:22313595 DOI: https://doi.org/10.5732/cjc.011.10328

World Health Organization. Comprehensive Cervical Cancer Control. 2nded. A Guide to Essential Practice. Geneva: World Health Organization Press; 2014.

Globacan. Indonesia. The Global Cancer Observatory; 2019. Available from: https://www.gco.iarc.fr/today/data/factsheets/populations/360-indonesia-fact-sheets.pdf [Last accessed on 2021 Apr 27].

Hashim NA, Ramzi NH, Velapasamy S, Alex L, Chahil JK, Lye SH, et al. Identification of genetic and non-genetic risk factors for nasopharyngeal carcinoma in a southeast Asian population. Asian Pac J Cancer Prev. 2012;13(12):6005-10. https://doi.org/10.7314/apjcp.2012.13.12.6005 PMid:23464394 DOI: https://doi.org/10.7314/APJCP.2012.13.12.6005

Zhang X, Sjöblom T. Targeting loss of heterozygosity: A novel paradigm for cancer therapy. Pharmaceuticals (Basel). 2021;14(1):57. https://doi.org/10.3390/ph14010057 PMid:33450833 DOI: https://doi.org/10.3390/ph14010057

Wu L, Li C, Pan L. Nasopharyngeal carcinoma: A review of current updates. Exp Ther Med. 2018;15(4):3687-92. https://doi.org/10.3892/etm.2018.5878 PMid:29556258 DOI: https://doi.org/10.3892/etm.2018.5878

Okekpa SI, Mydin RB, Mangantig E, Azmi NS, Zahari SN, Kaur G, et al. Nasopharyngeal carcinoma (NPC) risk factors: A systematic review and meta-analysis of the association with lifestyle, diets, socioeconomic and sociodemographic in Asian region. Asian Pac J Cancer Prev. 2019;20(11):3505-14. https://doi.org/10.31557/APJCP.2019.20.11.3505 PMid:31759378 DOI: https://doi.org/10.31557/APJCP.2019.20.11.3505

Banko A, Lazarevic IB, Folic MM, Djukic VB, Cirkovic AM, Karalic DZ, et al. Characterization of the variability of Epstein- Barr virus genes in nasopharyngeal biopsies: Potential predictors for carcinoma progression. PLoS One. 2016;11(4):e0153498. https://doi.org/10.1371/journal.pone.0153498 PMid:27071030 DOI: https://doi.org/10.1371/journal.pone.0153498

Hutajulu SH, Ng N, Jati BR, Fachiroh J, Herdini C, Hariwiyanto B, et al. Seroreactivity against Epstein–Barr virus (EBV) among first-degree relatives of sporadic. EBV-associated nasopharyngeal carcinoma in Indonesia. J Med Virol. 2012;84(5):768-76. https://doi.org/10.1002/jmv.23263 PMid:22431025 DOI: https://doi.org/10.1002/jmv.23263

Jayalie V, Paramitha MS, Jessica J, Liu CA, Ramadianto AS, Trimartani T, et al. Profile of Nasopharyngeal Carcinoma in Dr. Cipto Mangunkusumo National Hospital 2010. J Kedokteran Indones. 2016;4(3):156-62. DOI: https://doi.org/10.23886/ejki.4.7110.156-62

Sihotang T, Paramita D. Identifikasi Peptida Early Antigen Virus Epstein-Barr (EA-EBV) Sebagai Kandidat Penanda Diagnosis Karsinoma Nasofaring. Indonesia: Universitas Gadjah Mada; 2014.

Rahman S, Kurniawan H, Budiman BJ, Yerizel E, Bachtiar H. Evaluation of serum IgA antibodies to Epstein-Barr virus early and viral capsid antigens in nasopharyngeal carcinoma. KnE Eng. 2019;1:275. DOI: https://doi.org/10.18502/keg.v1i2.4452

Nikakhlagh S, Rahim F, Khodadi A, Saki N. The association between Epstein-Barr virus with nasopharyngeal carcinoma in patients from southwestern region of Iran. Int J Cancer Res. 2010;6:89-94. DOI: https://doi.org/10.3923/ijcr.2010.89.94

Hutajulu SH, Fachiroh J, Argy G, Indrasari SR, Jati TB, Paramita DK, et al. Seroprevalence of IgA anti Epstein-Barr virus is high among family members of nasopharyngeal cancer patients and individuals presenting with chronic complaints in head and neck area. PLoS One. 2017;12(8):e0180683. https://doi.org/10.1371/journal.pone.0180683 PMid:28800616 DOI: https://doi.org/10.1371/journal.pone.0180683

Raditya IG, Suanda IK, Asthuta AR. Differences of mean platelet volume (MPV) value among clinical stage of undifferentiated type nasopharyngeal carcinoma patient at ORL-HNS outpatient, Sanglah general hospital denpasar. Int J Nasopharyngeal Carcinoma. 2021;3(1):10-3. https://doi.org/10.32734/ijnpc.v3i01.5726 DOI: https://doi.org/10.32734/ijnpc.v2i01.2652

Farhat F, Sari MI, Chrestella J, Syari RP. The genetic variant of GSTP1 and immune response of immunoglobulin A (IgA) on nasopharyngeal carcinoma patients. IOP Conf Ser Earth Environ Sci. 2021;713:6-13. DOI: https://doi.org/10.1088/1755-1315/713/1/012052

RS Kanker Dharmais. Kanker Nasofaring, Kasus Keganasan Baru? RS Kanker Dharmais; 2019. Available from: https://www.dharmais.co.id/news/489/Kanker-Nasofaring,-Kasus-Keganasan-Baru [Last accessed on 2021 Apr 27]

Anugrahani A, Soeseno B, Dewi YA, Aroean NK. The comparison of elevated levels of Ebv immunoglobulin a early antigen between nasopharyngeal carcinoma who Type 3 with malignant non-hodgkin Lymphoma. Int J Nasopharyngeal Carcinoma. 2019;1(2):41-4. https://doi.org/10.32734/ijnpc.v1i2.1137 DOI: https://doi.org/10.32734/ijnpc.v1i2.1137

Sun Y, Sun C, Zhang E. Expression of serum sialic acid, early antigen-Ig A, and viral capsid antigen-Ig A in nasopharynx cancer patients: The diagnostic implication of combined assays. Med Sci Monit. 2015;28:4068-73. https://doi.org/10.12659/msm.894951 PMid:26709095 DOI: https://doi.org/10.12659/MSM.894951

Jassim MM, Mahmood MM, Hussein MH. Human Herpetic Viruses and Immune. IntechOpen: Innate Immunity in Health and Disease; 2021.

Perez EM, Foley J, Tison T, Silva R, Ogembo JG. Novel Epstein- Barr virus-like particles incorporating gH/gLEBNA1 or gB-LMP2 induce high neutralizing antibody titers and EBV-specific T-cell responses in immunized mice. Oncotarget. 2017;8(12):19255- 73. https://doi.org/10.18632/oncotarget.13770 PMid:27926486 DOI: https://doi.org/10.18632/oncotarget.13770

Coghill A, Hildesheim A. Epstein-Barr virus antibodies and the risk of associated malignancies: Review of the literature. Am J Epidemiol. 2014;180(7):687-95. https://doi.org/10.1093/aje/kwu176 PMid:25167864 DOI: https://doi.org/10.1093/aje/kwu176

Rao D, Fu M, Chen Y, Liu Q, Xiao L, Zhang X, et al. A combination of two ELISA tests for nasopharyngeal carcinoma screening in endemic areas based on a case-control study. PeerJ. 2020;8:e10254. https://doi.org/10.7717/peerj.10254 PMid:33240616 DOI: https://doi.org/10.7717/peerj.10254

Zhou T, Yang D, He Y, Xue WQ, Liao Y, Zheng MQ, et al. Associations between environmental factors and serological Epstein-Barr virus antibodies in patients with nasopharyngeal carcinoma in South China. Cancer Med. 2019;8(10):4852-66. https://doi.org/10.1002/cam4.2348 PMid:31241250 DOI: https://doi.org/10.1002/cam4.2348

Du JL, Chen SH, Huang QH, Xie SH, Ye YF, Gao R, et al. Subtype distribution and long-term titer fluctuation patterns of serum anti-Epstein-Barr virus antibodies in a non-nasopharyngeal carcinoma population from an endemic area in South China: A cohort study. Chin J Cancer. 2016;35(1):78. https://doi.org/10.1186/s40880-016-0130-2 PMid:27527073 DOI: https://doi.org/10.1186/s40880-016-0130-2

Januardi R, Dewi YA, Basriyadi T. Correlation of IgA-EA Epstein Barr virus with risk factors on nasopharyngeal carcinoma Type III. Int J Nasopharyngeal Carcinoma. 2020;2(3):71-3. https://doi.org/10.32734/ijnpc.v2i03.4507