• 1 Molecular Pathology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
  • 2 Department of Otorhinolaryngology, Selayang Hospital, Ministry of Health Malaysia, Batu Caves, Selangor, Malaysia
  • 3 Department of Oncology and Radiotherapy, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
  • 4 Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
Int. J. Cancer, 2019 10 15;145(8):2260-2266.
PMID: 30698824 DOI: 10.1002/ijc.32173


Nasopharyngeal carcinoma (NPC) is an epithelial cancer of the nasopharynx which is highly associated with Epstein-Barr virus (EBV). Worldwide, most of the top 20 countries with the highest incidence and mortality rates of NPC are low- and middle-income countries. Many studies had demonstrated that EBV could be detected in the tissue, serum and plasma of NPC patients. In this study, we explored the potential of assays based on non-invasive nasal washings (NW) as a diagnostic and prognostic tool for NPC. A total of 128 patients were evaluated for NW EBV DNA loads and a subset of these samples were also tested for 27 EBV and human miRNAs shortlisted from literature. EBV DNA and seven miRNAs showed area under the receiver operating characteristic curve (AUC) values of more than 0.7, suggestive of their potential utility to detect NPC. Logistic regression analyses suggested that combination of two NW assays that test for EBNA-1 and hsa-miR-21 had the best performance in detecting NPC. The trend of NW EBV DNA load matched with clinical outcome of 71.4% (10 out of 14) NPC patients being followed-up. In summary, the non-invasive NW testing panel may be particularly useful for NPC screening in remote areas where healthcare facilities and otolaryngologists are lacking, and may encourage frequent testing of individuals in the high risk groups who are reluctant to have their blood tested. However, further validation in an independent cohort is required to strengthen the utility of this testing panel as a non-invasive detection tool for NPC.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.