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Chemokine CCL27 is a novel plasma biomarker for identification the nasopharyngeal carcinoma patients from the Epstein-Barr virus capsid antigenspecific IgA seropositive population



Background: To investigate the predictive value of chemokine CCL27 for identifying early stage nasopharyngeal
carcinoma (NPC) patients within a population seropositive for Epstein-Barr virus (EBV) capsid antigen-specific IgA
(VCA-IgA).
Methods: CCL27 in plasma samples from 104 NPC patients, 112 VCA-IgA–positive healthy donors, and 140
VCA-IgA–negative normal subjects was measured by ELISA. Expression of CCL27 in nasopharyngeal tissue from
20 VCA-IgA–positive healthy donors and 20 NPC patients was examined by immunohistochemical staining.
Results: Levels of CCL27 in the plasma of VCA-IgA–positive healthy donors (607.33 ± 218.81 pg/ml) were significantly
higher than the levels in all NPC patients (437.09 ± 217.74, P = < 0.0001) and in the subset of patients with early stage
NPC (463.85 ± 226.17, P = 0.0126). Plasma CCL27 levels were significantly lower in the VCA-IgA–negative normal subjects
(358.22 ± 133.15 pg/ml) than in either the VCA-IgA–positive healthy donors (P < 0.0001) or the NPC patients (P = 0.0113).
CCL27 protein was detected in 16 of 20 (80%) nasopharyngeal tissue samples from VCA-IgA–positive healthy donors and
in 3 of 20 (15%) tumor tissue samples from NPC patients. There was no relationship between CCL27 levels and VCA-IgA
titers or plasma EBV DNA content. Receiver operating characteristic (ROC) curves demonstrated that plasma CCL27 levels
had a sensitivity of 67.00%, a specificity of 73.10%, and an area under the ROC of 0.725 (95% confidence interval [CI]: 0.
657–0.793) for distinguishing between NPC patients and VCA-IgA–positive healthy donors. Further analysis showed that
CCL27 levels could distinguish between early stage NPC patients and VCA-IgA–positive healthy donors with an area
under the ROC of 0.712 (95% CI: 0.560–0.865), a sensitivity of 59.80%, and a specificity of 84.60%.
Conclusions: Chemokine CCL27 could successfully identify NPC patients within a VCA-IgA–positive population.


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