Presence of lytic Epstein-Barr virus infection in nasopharyngeal carcinoma

Head Neck. 2018 Jul;40(7):1515-1523. doi: 10.1002/hed.25131. Epub 2018 Mar 9.

Abstract

Background: Chromogenic Epstein-Barr virus-encoded RNA (EBER) in situ hybridization (EBER-ISH) is the gold standard to detect Epstein-Barr virus (EBV) but it is difficult to use in conjunction with immunohistochemistry (IHC). In this study, our purpose was to validate the sensitivity and specificity of RNAscope in detection of EBV infection in nasal epithelium and its stroma.

Methods: Fluorescence-based RNAscope EBER-ISH, BRLF1-ISH, and lineage marker-IHC were performed on archived formalin-fixed paraffin-embedded tissues from normal nasal cavity (n = 5), nasopharynx (n = 8), and nasopharyngeal carcinoma (NPC) specimens (n = 10).

Results: The EBERs were detected in 10 of 10 NPC samples but was absent in all normal tissues from the nasal cavity and nasopharynx. The EBERs were exclusively located in pan-cytokeratin (pan-CK)-positive tumor epithelial cells but not in CD45-positive leukocytes and vimentin-positive stromal fibroblasts. The level of EBER expression varied in tumor cells within patient and between patients as well. Additionally, 5 of 10 patients had positive BRLF-ISH.

Conclusion: We developed a simple and reproducible method to simultaneously detect mRNA and protein in formalin-fixed paraffin-embedded tissues of NPC. As a single staining, traditional EBER continues to be useful; however, for interpretation of the phenotype of EBV-infected cells, RNAscope is superior. Significantly, we showed that lytic EBV infection took place in NPC tumors.

Keywords: BRLF1 gene; Epstein-Barr virus; Epstein-Barr virus-encoded RNA (EBER); RNAscope in situ hybridization; immunohistochemistry; nasopharyngeal carcinoma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Epstein-Barr Virus Infections / diagnosis*
  • Female
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification
  • Humans
  • In Situ Hybridization*
  • Male
  • Middle Aged
  • Nasal Mucosa / virology
  • Nasopharyngeal Carcinoma / virology*
  • RNA, Viral / analysis*

Substances

  • RNA, Viral