Sensitivity and specificity of Epstein-Barr virus IGA titer in the diagnosis of nasopharyngeal carcinoma: a three-year institutional review

BACKGROUND

IgA antibody titers to the Epstein-Barr virus (EBV) viral capsid antigen (EBV IgA-VCA) and to the EBV early antigen (EBV IgA-EA) are used to screen for nasopharyngeal carcinoma (NPC). This study evaluates the sensitivity and specificity of EBV IgA-VCA and EBV IgA-EA titers in screening patients for NPC and in those diagnosed with NPC at our institution.

METHODS

The NPC status was determined for all patients who had their EBV IgA-VCA and EBV-IgA EA titers measured over a 3-year period, and the sensitivity and specificity were calculated.

RESULTS

Five thousand one hundred ninety-six samples were analyzed. NPC was diagnosed in 215 patients. The sensitivity and specificity of a raised EBV IgA-VCA titer (> or =1:5) for diagnosing NPC were 89% and 80%, respectively, with a raised EbV IgA-EA titer (> or =1:5) having a sensitivity and specificity of 63% and 97%, respectively.

CONCLUSIONS

Although the EBV IgA-VCA titer is sensitive for the diagnosis of NPC, it should not be used as the sole means of screening for NPC in a population in which NPC is endemic.

Effects of gender, Helicobacter pylori and hepatitis B virus serology status on cardiovascular and renal complications in Chinese type 2 diabetic patients with overt nephropathy

BACKGROUND

The aim of this study was to investigate whether chronic infections with Helicobacter pylori and hepatitis B virus (HBV) might affect clinical outcomes in Chinese type 2 diabetic patients with advanced nephropathy.

METHODS

A prospective study of 97 type 2 diabetic patients with clinical proteinuria and renal insufficiency (median serum creatinine 200 micro mol/l).

RESULTS

During a median follow-up period of 2 years, 34 developed end-stage renal disease (ESRD), 28 had cardiovascular endpoints and 11 patients had died (seven men and four women), and 52.7% developed a combined endpoint. Female patients had longer disease duration, higher blood pressure, lower body weight but higher serum creatinine and spot urine albumin : creatinine ratio as well as lower haemoglobin than male patients. On logistic regression analysis, female gender (hazard ratio: 5.91, p = 0.02), negative H. pylori serology (8.39, p = 0.004), baseline serum creatinine (1.04, p = 0.001) and haemoglobin (1.86, p = 0.01) were independent predictors for ESRD. Systolic blood pressure (1.04, p = 0.003), prior treatment with angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists (3.41, p = 0.04) and positive hepatitis B surface antigen (4.88, p = 0.025) were independent predictors for cardiovascular endpoints. Female gender (7.89, p = 0.002) and baseline serum creatinine (1.05, p < 0.001) were independent predictors for combined death and cardio-renal endpoints.

CONCLUSIONS

In Chinese type 2 diabetic patients with clinical proteinuria renal insufficiency, there were high rates of death and cardio-renal outcomes. Female gender, low haemoglobin and negative H. pylori serology were important predictors for ESRD, whereas chronic HBV infection was associated with increased cardiovascular risks.

Oseltamivir prophylaxis during the influenza season in a paediatric cancer centre: prospective observational study

OBJECTIVE

To determine the role of oseltamivir prophylaxis for immunocompromised patients.

DESIGN

Prospective, non-blinded, non-controlled observational study.

SETTING

A paediatric cancer centre, Hong Kong.

PARTICIPANTS

Thirty-two patients, immunocompromised by chemotherapy or bone marrow transplantation during an influenza season in 2001.

INTERVENTION

Oral oseltamivir prophylaxis 75 mg/d for 8 weeks.

MAIN OUTCOME MEASURES

Laboratory-confirmed influenza infection, symptoms of influenza, drug compliance, and any side-effects from oseltamivir treatment. Laboratory monitoring included virological surveillance for influenza A and B, blood counts, and renal and liver function tests.

RESULTS

Patients' median age was 14.3 years (range, 6.3-23.4 years). Underlying conditions included malignancy (n=29) and other haematological diseases (n=3). No documented influenza infection according to serological tests was present throughout the study period. Five patients with symptoms of upper respiratory tract infection did not have any influenza infection detected by rapid virological assay and viral culture. For 16% of patients, the main side-effect in the study was gastro-intestinal upset.

CONCLUSIONS

Oral oseltamivir 75 mg once daily for 8 weeks may be useful in the prevention of influenza infection in patients immunocompromised by chemoradiotherapy; side-effects are few and acceptable.

Prevalence of human papillomavirus in cervical cancer: a multicenter study in China

A large-scale epidemiologic survey on the prevalence of different types of human papillomavirus (HPV) in cervical cancer in China is indicated because of the implications for the development of diagnostic probes and vaccines against cervical cancer. A total of 809 cervical cancer specimens were collected from 5 regions in China including Shanghai, Guangzhou, Sichuan, Beijing and Hong Kong. HPV DNA was detected in 83.7% of the specimens. HPV-16 was present in 79.6%, HPV-18 in 7.5%, HPV-52 in 2.6% and HPV-58 in 3.8% of all HPV-positive specimens. The prevalences of HPV-16 and HPV-18 in Hong Kong were 61.7 and 14.8%, respectively, representing a lower HPV-16 and a higher HPV-18 proportion compared with the other regions. HPV-16 remained the most common HPV infection in both squamous cell carcinoma (SCC) and adenocarcinoma (AC). The proportion of HPV-18 infection was significantly higher in AC than in SCC.