Assessment of Epstein-Barr Virus in Patients with Squamous Cell Carcinoma of the Larynx by Real-Time Polymerase Chain Reaction
DOI:
https://doi.org/10.22317/jcms.v7i6.1097Keywords:
Epstein-Barr virus, Laryngeal squamous cell carcinoma, Real-Time Polymerase Chain Reaction.Abstract
Objectives: This study was conducted to investigate the presence of Epstein- Barr virus (EBV) as a risk factor in laryngeal squamous cell carcinoma (SCC) and its effects on the pathological and clinical features of this disease.
Methods: This cross-sectional study was conducted on 55 patients with histologically confirmed laryngeal SCC in the pathology department of Shafa and Afzalipour hospital, Kerman, Iran, referred to the radiation oncology department between January 2018 and May 2019 (study group). Thirty-five patients who underwent surgery for benign laryngeal lesions such as polyps, nodules, cysts, or granulomas were considered as the control group. Biopsy specimens of all subjects were examined for the presence of EBV DNA by Real-Time Polymerase Chain Reaction (RT-PCR). Demographic and clinicopathological characteristics of all patients were recorded and patients with laryngeal SCC were followed up regarding relapse. The data were analyzed using SPSS-17 software and descriptive and analytical statistics were done.
Results: The incidence of EBV infection in patients with laryngeal SCC was 32.7 % (95% CI: 5 / 45- 21/8) and this amount was 2.9 % (95% CI: 0-8.6) in the control group. Based on multivariate logistic regression model, age (OR:1.05, 95% Cl: 1.00 - 1.10, P-value: 0.04), EBV (OR :9.76, 95% Cl: 1.07 - 88.59, P-value:0.04), smoking (OR: 6.82, 95% CI: 1.69 – 27.53, P-value: 0.007) and opium consumption (OR: 6.46, 95% CI: 1.36 - 30.66, P-value: 0.01) were determined as predictors of laryngeal SCC. In the patients’ group, the presence of EBV was associated with a higher lymph node stage, which was statistically significant but there was no significant relationship in terms of age, sex, tumor location and T stage and, relapse.
Conclusion: This study showed an association between EBV as a risk factor and laryngeal SCC.
References
2. Marur S, Forastiere AA, editors. Head and neck cancer: changing epidemiology, diagnosis, and treatment. Mayo Clinic Proceedings; 2008: Elsevier.
3. Ahmadi N, Ahmadi N, Chan MV, Huo YR, Sritharan N, Chin R. Laryngeal squamous cell carcinoma survival in the context of human papillomavirus: a systematic review and meta-analysis. Cureus. 2018;10(2).
4. Muderris T, Rota S, Muderris T, Inal E, Fidan I. Does Epstein-Barr virus infection have an influence on the development of laryngeal carcinoma? Detection of EBV by Real-Time Polymerase Chain Reaction in tumour tissues of patients with laryngeal carcinoma. Brazilian journal of otorhinolaryngology. 2013;79(4):418-23.
5. Gupta I, Ghabreau L, Al-Thawadi H, Yasmeen A, Vranic S, Al Moustafa A-E, et al. Co-incidence of Human Papillomaviruses and Epstein–Barr Virus Is Associated With High to Intermediate Tumor Grade in Human Head and Neck Cancer in Syria. Frontiers in Oncology. 2020;10:1016.
6. de Oliveira DE, Bacchi MM, Macarenco RS, Tagliarini JV, Cordeiro RC, Bacchi CE. Human papillomavirus and Epstein-Barr virus infection, p53 expression, and cellular proliferation in laryngeal carcinoma. American journal of clinical pathology. 2006;126(2):284-93.
7. Vazquez-Guillen JM, Palacios-Saucedo GC, Rivera-Morales LG, Alonzo-Morado MV, Burciaga-Bernal SB, Montufar-Martinez M, et al. Infection and coinfection by human papillomavirus, Epstein–Barr virus and Merkel cell polyomavirus in patients with squamous cell carcinoma of the larynx: a retrospective study. PeerJ. 2018;6:e5834.
8. Kiaris H, Ergazaki M, Segas J, Spandidos D. Detection of Epstein-Barr virus genome in squamous cell carcinomas of the larynx. The International journal of biological markers. 1995;10(4):211-5.
9. Mousa MJ. The Frequency of Epstein-Barr Virus Infection As A Pathogenic Agent In Laryngeal Carcinoma of Iraqi Patients Demonstrated By LMP-1 Expression. Journal of University of Babylon. 2016;24(3).
10. Saedi B, Razmpa E, Sadeghi M, Mojtahed M, Mojtahed A. The epidemiology of laryngeal cancer in a country on the esophageal cancer belt. Indian Journal of Otolaryngology and Head & Neck Surgery. 2009;61(3):213-7.
11. Emadzadeh M, Shahidsales S, Bajgiran AM, Salehi M, Massoudi T, Nikfarjam Z, et al. Head and neck cancers in North-East Iran: a 25 year survey. Iranian journal of otorhinolaryngology. 2017;29(92):137.
12. Larizadeh MH, Damghani MA, Shabani M. Epidemiological characteristics of head and neck cancers in southeast of Iran. Iranian journal of cancer prevention. 2014;7(2):80.
13. Zykova T, Kit OI, Vladimirova LY, Ryadinskaya LA, Shevyakova EA, Bogomolova OA, et al. Impact of viral infection on effectiveness of antitumor treatment for laryngeal cancer. American Society of Clinical Oncology; 2018.
14. Mulder FJ, Klufah F, Janssen FM, Farshadpour F, Willems SM, de Bree R, et al. Presence of human papillomavirus and Epstein–Barr virus, but absence of Merkel cell polyomavirus, in head and neck Cancer of non-smokers and non-drinkers. Frontiers in oncology. 2021;10:3048.
15. Prabhu SR, Wilson DF. Evidence of Epstein-Barr virus association with head and neck cancers: a review. J Can Dent Assoc. 2016;82(g2):1488-2159.
16. Lee L-A, Fang T-J, Li H-Y, Chuang H-H, Kang C-J, Chang K-P, et al. Effects of epstein-barr virus infection on the risk and prognosis of primary laryngeal squamous cell carcinoma: A hospital-based case-control study in taiwan. Cancers. 2021;13(7):1741.
17. Halmos G, Bras L, Siesling S, van der Laan B, Langendijk J, van Dijk B. Ageâ€specific incidence and treatment patterns of head and neck cancer in the Netherlands—A cohort study. Clinical otolaryngology. 2018;43(1):317-24.
18. Zhang Y, Chen X, Xia L, Can L, Dan L, Ruixia M, et al. Correlation of positive expressions of HPV and EBV with laryngeal carcinoma. The Journal of Practical Medicine. 2017;33(13):2117-22.
19. Nocini R, Molteni G, Mattiuzzi C, Lippi G. Updates on larynx cancer epidemiology. Chinese Journal of Cancer Research. 2020;32(1):18.
20. Alizadeh H, Naghibzadeh-Tahami A, Khanjani N, Yazdi-Feyzabadi V, Eslami H, Borhaninejad V, et al. Opium use and head and neck cancers: a matched case-control study in Iran. Asian Pacific journal of cancer prevention: APJCP. 2020;21(3):783.
21. BÅ™icháÄek B, Hirsch I, Å Ãbl O, Vilikusova E, Vonka V. Association of some supraglottic laryngeal carcinomas with EB virus. International journal of cancer. 1983;32(2):193-7.
22. Al-Thawadi H, Gupta I, Jabeen A, Skenderi F, Aboulkassim T, Yasmeen A, et al. Co-presence of human papillomaviruses and Epstein–Barr virus is linked with advanced tumor stage: a tissue microarray study in head and neck cancer patients. Cancer Cell International. 2020;20(1):1-13.
23. Vlachtsis K, Nikolaou A, Markou K, Fountzilas G, Daniilidis I. Clinical and molecular prognostic factors in operable laryngeal cancer. European Archives of Oto-Rhino-Laryngology and Head & Neck. 2005;262(11):890-8.
24. Polz-Gruszka D, Stec A, DWORZAŃSKI J, POLZ-DACEWICZ M. EBV, HSV, CMV and HPV in laryngeal and oropharyngeal carcinoma in Polish patients. Anticancer research. 2015;35(3):1657-61.