International Journal of Head and Neck Surgery

Register      Login

VOLUME 11 , ISSUE 1 ( January-March, 2020 ) > List of Articles

Original Article

Comparison between ELISA and PCR for Detection of Epstein-Barr Virus in Head and Neck Malignancies

Shahid Rasool, Rafiq A Pampori, Sabhiya Majid, Hilal Wani, Rabiya Farooq, Suhail Patigaroo

Keywords : ELISA for Epstein-Barr virus, Epstein-Barr virus, Head and neck carcinomas, Laryngeal carcinomas, Oral tumors, PCR for Epstein-Barr virus

Citation Information : Rasool S, Pampori RA, Majid S, Wani H, Farooq R, Patigaroo S. Comparison between ELISA and PCR for Detection of Epstein-Barr Virus in Head and Neck Malignancies. Int J Head Neck Surg 2020; 11 (1):6-11.

DOI: 10.5005/jp-journals-10001-1389

License: CC BY-NC 4.0

Published Online: 30-05-2020

Copyright Statement:  Copyright © 2020; The Author(s).


This is a comparative prospective study conducted for a period of 2 years from December 2012 to December 2014 in the Postgraduate Department of Otorhinolaryngology, Head and Neck Surgery, Government Medical College, Srinagar, in collaboration with the Department of Biochemistry. A total of 118 subjects were enrolled in the study design, which included 98 histopathologically confirmed head and neck malignant cases and 20 healthy controls. The aim of the study was to compare the ELISA with polymerase chain reaction (PCR) for detection of Epstein-Barr virus (EBV) in head and neck carcinoma cases and compare such results with controls. Results: Around 32.65 and 42.85% of patients were positive for EBV with PCR and ELISA, respectively. When these results were compared with controls, it showed statistically significant results; only 5% of subjects in controls were positive for EBV (p value = 0.015) with PCR while as many as 15% with ELISA (p value = 0.049). The sensitivity and specificity of ELISA are 100 and 84.85%, respectively, with diagnostic accuracy of the test 89.8% (Cohens κ value = 0.7853).

  1. Goldenberg D, Golz A, Netzer A, et al. Epstein-Barr virus and cancers of the head and neck. Am J Otolaryngol 2001;22(3):197–205. DOI: 10.1053/ajot.2001.23429.
  2. Yang HJ, Cho YJ, Kim HS, et al. Association of p53 and BCL-2 expression with Epstein-Barr Virus infection in the cancers of head and neck. Head Neck 2001;23(8):629–636. DOI: 10.1002/hed.1089.
  3. Lin JC, Chen KY, Wang WY, et al. Detection of Epstein-Barr virus DNA in the peripheral-blood cells of patients with nasopharyngeal carcinoma: relationship to distant metastasis and survival. J Clin Oncol 2001;19(10):2607–2615. DOI: 10.1200/JCO.2001.19.10.2607.
  4. Parkin DM, Bray F, Ferlay J, et al. Global cancer Statistics. CA Cancer J Clin 2005;55(2):74–108, 2002.
  5. Blot WJ, Mclaughlin JK, Winn DM, et al. Smoking and Drinking in relation to oral and pharyngeal cancer. Cancer Res 1988;48(11): 3282–3287.
  6. Zeka A, Gore R, Kriebel D. Effects of alcohol and tobacco on aerodigestive cancer risks: a meta-regression analysis. Cancer Causes Control 2003;14(9):897–906. DOI: 10.1023/B:CACO.0000003854.34221.a8.
  7. Nair S, Pillai MR. Human papillomavirus and disease mechanisms: relevance to oral and cervical cancers. Oral Dis 2005;11(6):350–359. DOI: 10.1111/j.1601-0825.2005.01127.x.
  8. Lyons SF, Liebowitz DN. The roles of human viruses in the pathogenesis of lymphoma. Semin Oncol 1998;25(4):461–475.
  9. Lei KIK, Chan LYS, Chan WY, et al. Quantitative analysis of circulating cell-free Epstein-Barr virus (EBV) DNA levels in patients with EBV-associated lymphoid malignancies. Br J Haematol 2000;111(1):239–246. DOI: 10.1046/j.1365-2141.2000.02344.x.
  10. Shinokuma A, Hirakawa N, Tamiya S, et al. Evaluation of Epstein-Barr virus infection in sinonasal small round cell tumors. J Cancer Res Clin Oncol 2000;126(1):12–18. DOI: 10.1007/PL00008459.
  11. Cruz I, Van den Brule, Brink AJ, AA, et al. No direct role for Epstein-Barr virus in oral carcinogenesis: a study at the DNA, RNA and Protein levels. Int J Cancer 2000;86(3):356–361. DOI: 10.1002/(sici)1097-0215(20000501)86:3<356::aid-ijc9>;2-w.
  12. Cruz I, Van den Brule, Steenbergen AJ, RD, et al. Prevalence of Epstein-Barr virus in oral squamous cell carcinomas, premalignant lesions and normal mucosa–a study using the polymerase chain reaction. Oral Oncol 1997;33(3):182–188. DOI: 10.1016/S0964-1955(96)00054-1.
  13. Kobayashi I, Shima K, Saito I, et al. Prevalence of Epstein-Barr virus in oral squamous cell carcinoma. J Pathol 1999;189(1):34–39. DOI: 10.1002/(SICI)1096-9896(199909)189:1<34::AID-PATH391>3.0.CO;2-4.
  14. Maeda T, Hiranuma H, Matsumura S, et al. Epstein-Barr virus infection and response to radiotherapy in squamous cell carcinoma of the oral cavity. Cancer Lett 1998;125(1–2):25–30. DOI: 10.1016/S0304-3835(97)00485-0.
  15. Gonzalez-Moles M, Gutierrez J, Ruiz I, et al. Epstein-Barr virus and oral squamous cell Carcinoma in patients without HIV infection: viral detection by polymerase Chain reaction. Microbios 1998;96(383): 23–31.
  16. Lin H, Rao H, Saku U. The significance of detecting EB. Virus and its products in benign and malignant lymphoepithelial lesions of the salivary glands (Chinese). Chung-Hua Ping Li Hsueh Tsa Chih – Chinese J Pathol 1997;26:225–228.
  17. Leung SY, Chung LP, Yuen ST, et al. Lymphoepithelial carcinoma of the salivary gland: in Situ detection of Epstein-Barr virus. J Clin Pathol 1995;48(11):1022–1027. DOI: 10.1136/jcp.48.11.1022.
  18. Shimakage M, Sasagawa T, Yoshino K, et al. Expression of Epstein-Barr virus in nasopharyngeal and hypopharyngeal carcinomas. Hum Pathol 1999;30(9):1071–1076.
  19. Frank DK, Cheron F, Cho H, et al. Nonnasopharyngeal lymphoepitheliomas (undifferentiated carcinomas) of the upper aerodigestive tract. Ann Otol Rhinol Laryngol 1995;104(4 Pt 1):305–310. DOI: 10.1177/000348949510400410.
  20. Kim KI, Kim YS, Kim HK, et al. The detection of Epstein-Barr virus in the lesions of salivary Glands. Pathol Res Pract 1999;195(6):407–412. DOI: 10.1016/S0344-0338(99)80014-4.
  21. Luna MA. Salivary glands. In: Pilch BZ. ed. Head and Neck Surgical Pathology. Philadelphia: Lippincott Williams and Wilkins; 2001. pp. 284–349.
  22. Fahraeus R, Fu HL, Ernberg I, et al. Expression of Epstein-Barr virus-encoded proteins in nasopharyngeal carcinoma. Int J Cancer 1988;42(3):329–338. DOI: 10.1002/ijc.2910420305.
  23. Young LS, Dawson CW, Clark D, et al. Epstein-Barr virus Gene expression in nasopharyngeal carcinoma. J Gen Virol 1988;69(5): 1051–1065. DOI: 10.1099/0022-1317-69-5-1051.
  24. Chapman A, Rickinson A. Epstein-Barr virus in Hodgkin's disease. Ann Oncol 1998;9(Suppl 5):S5–S16. DOI: 10.1093/annonc/9.suppl_5.S5.
  25. Jones J, Shurin S, Abramowsky C, et al. T-Cell lymphomas containing Epstein-Barr viral DNA in patients with chronic Epstein-Barr virus infections. N Engl J Med 1988;318:733–741. DOI: 10.1056/NEJM198803243181203.
  26. Weiss L, Jaffe E, Liu X, et al. Detection and localization of Epstein-Barr viral genomes in angioimmunoblastic lymphadenopathy-like lymphomas. Blood 1992;79(7):1789–1795.
  27. Yu KH, Dennis Lo YM, Tse GM, et al. Quantitative Analysis of Cell-Free Epstein-Barr Virus DNA in Plasma of Patients with Nonnasopharyngeal Head and Neck carcinoma. Clin Cancer Res 2004;10(5):1726–1732. DOI: 10.1158/1078-0432.CCR-0991-3.
  28. Atlana GA. American Cancer Society. Retrieved December 26, 2012.
  29. Abdulamir AS, Hafidh RR, Abdulmuhaimen N, et al. The distinctive profile of risk factors of nasopharyngeal carcinoma In comparison with other head and neck cancer types. BMC Public Health 2008;8:400. DOI: 10.1186/1471-2458-8-400.
  30. Kamel AH, el-Barawy, Hashish MH. Epstein-Barr virus in head and neck squamous cell carcinoma. East Mediterr Health J 2003;9(3): 364–371.
  31. National Cancer Institute. Head and Neck Cancers. Reviewed February 1, 2013.
  32. Wyss A, Hashibe M, Chuang S-C, et al. Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium. Am J Epidemiol 2013;178(5):679–690. DOI: 10.1093/aje/kwt029.
  33. Majid M, Rafat Panah H, Zamanian A. Epstein – Barr virus antibody titers in non nasopharyngeal head and neck squamous cell carcinoma. Iran J Otorhinolaryngol 2006;18(45):61–65.
  34. Muderris T, Rota S, Muderris T. Erdogan İnal, Isıl Fidan. 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. Braz J Otorhinolaryngol 2013;79(4):418–423. DOI: 10.5935/1808-8694.20130075.
  35. Mao EJ, Smith CJ. Detection of Epstein-Barr virus (EBV) DNA by the polymerase chain reaction (PCR) in oral smears from healthy individuals and patients with oral squamous cell carcinoma. J Oral Pathol Med 1993;22(1):12–17. DOI: 10.1111/j.1600-0714.1993.tb00112.x.
  36. Horiuchi K, Mishima K, Ichijima K, et al. Epstein-Barr virus in the proliferative diseases of squamous epithelium in the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;79(1):57–63. DOI: 10.1016/S1079-2104(05)80075-7.
  37. Sand LP, Jalouli, Larsson PA, et al. Prevalence of Epstein Barr Virus in oral squamous cell carcinoma, oral lichen planus and normal oral mucosa. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod 2002; 93(5):586–592. DOI: 10.1067/moe.2002.124462.
  38. D, Tiwawech, S, Chindavijak, P, Saelee, et al. Detection of IgA Antibody Against Epstein–Barr Virus Nuclear Antigen 1 in Nasopharyngeal Carcinoma Patients by ELISA. Thai Cancer J 2008;28(2):83–92.
  39. Twu C-W, Wang W-Y, Liang W-M, et al. Comparison of the prognostic impact of serum anti-EBV antibody and plasma EBV DNA assays in nasopharyngeal carcinoma. Int J Radiation Oncology Biol, Phys 2007;67(1):130–137. DOI: 10.1016/j.ijrobp.2006.07.012.
  40. Trimeche M, Ziadi S, De Leval L, et al. Prevalence of Epstein-Barr Virus in non-Hodgkin's lymphomas in central region of Morshed K, Dacewiez PS, Zymanski M, Rajtar B, Ziaja SM. Epstein–Barr Virus antibodies in patients With Laryngeal and hypopharyngeal cancer. Ann Univ Mariae Curie Sklodowska 2003;58(2):227–231.
  41. Morshed K, Polz-Dacewicz M, Szymański M, et al. Epstein-Barr virus antibodies in patients with laryngeal and hypopharyngeal cancer. Ann Univ Mariae Curie Sklodowska Med 2003;58(2):227–231.
  42. Kim A-Y, Jong-Lyel, Kim JM. Association of Epstein Barr Virus in Head and Neck cancer in an endemic area. Korean J Otolaryngol Head Neck Surg 2007;50(3):235–239.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.