HUBUNGAN PENINGKATAN ANTIBODY Ig A ANTI EA EBV PADA PASIEN PENDERITA KNF PADA SUKU NIAS
Abstract
Nasopharyngeal carcinoma (NPC) is a malignant tumor of the head and neck region, predominantly found in Southeast Asia, and is closely associated with Epstein–Barr Virus (EBV) infection. Detection of Immunoglobulin A (IgA) antibodies against the Early Antigen (EA) of EBV has been recognized as a potential non-invasive biomarker for early diagnosis. Genetic, environmental, and lifestyle factors — including the traditional habit of consuming preserved foods among the Nias ethnic group — are believed to influence the antibody response. This study aimed to analyze the association between elevated IgA anti-EA EBV antibody levels and the occurrence of NPC among Nias patients. An observational analytic study with a case–control design was conducted involving 29 NPC patients and 29 healthy Nias individuals as controls. Serum samples were examined serologically at the Integrated Laboratory, Faculty of Medicine, University of North Sumatra. Data were analyzed using the Chi-square and Mann–Whitney tests. The findings revealed that the mean level of IgA anti-EA EBV antibodies in NPC patients (246.22 ± 320.05 U/mL) was significantly higher than that of healthy controls (51.79 ± 1.55 U/mL) (p < 0.05). Positive serological reactivity was detected in 55.2% of NPC patients compared to 10.3% in the control group. No significant associations were found between age or gender and the serological results (p > 0.05). These results indicate that elevated IgA anti-EA EBV antibody levels may serve as an important immunological marker for early detection of NPC, particularly among high-risk populations such as the Nias ethnic group.
References
Banko, A., Lazarevic, I., Cupic, M., & Djuric, J. (2016). Epstein–Barr virus infection and nasopharyngeal carcinoma. Journal of BUON, 21(3), 593–598.
Bhaduri-McIntosh, S., Miller, G., & Shimizu, N. (2007). Epstein-Barr virus latent and lytic infection in B lymphocytes. Journal of Virology, 81(17), 9410–9420.
Chang, E. T., & Adami, H. O. (2006). The enigmatic epidemiology of nasopharyngeal carcinoma. Cancer Epidemiology, Biomarkers & Prevention, 15(10), 1765–1777.
Chen, Y., Liu, Q., & Chen, L. (2015). Epstein-Barr virus-associated nasopharyngeal carcinoma: a review and update. Journal of Cancer, 6(3), 285–293.
Coghill, A. E., & Hildesheim, A. (2014). Epstein-Barr virus antibodies and the risk of associated malignancies: review of the literature. American Journal of Epidemiology, 180(7), 687–695.
Du, T., Zhang, C., & He, Y. (2016). Association of Epstein–Barr virus reactivation with age and gender in nasopharyngeal carcinoma patients. Oncology Letters, 11(5), 3359–3365.
Farhat, M., Rahman, D., & Nasution, D. (2021). Profil pasien karsinoma nasofaring di Sumatera Utara. Jurnal Onkologi Klinik Indonesia, 13(1), 22–30.
Globocan. (2019). Nasopharyngeal carcinoma fact sheet. International Agency for Research on Cancer (IARC). https://gco.iarc.fr
Herdini, H., Hutajulu, S. H., & Adham, M. (2011). Kadar antibodi IgA anti-EBV pada pasien dengan gejala kronis kepala dan leher. Jurnal Kedokteran Gigi dan Mulut Indonesia, 23(2), 111–118.
Hsu, M. M., Chang, Y. L., & Hsu, C. H. (2001). Serologic markers of Epstein–Barr virus infection and nasopharyngeal carcinoma in Taiwan. Cancer, 91(6), 1137–1143.
Hutajulu, S. H., Hariwiyanto, B., & Adham, M. (2011). Epstein–Barr virus DNA load and specific antibody responses in Indonesian nasopharyngeal carcinoma patients. Oral Oncology, 47(4), 296–301.
Hutajulu, S. H., Paramita, D. K., & Adham, M. (2017). EBV serological profile in nasopharyngeal carcinoma: ethnic and geographical variations. Asian Pacific Journal of Cancer Prevention, 18(2), 495–502.
Ismail, A. (2017). Faktor makanan awetan terhadap kejadian karsinoma nasofaring di Sumatera Utara. Jurnal Gizi dan Kesehatan, 9(2), 45–52.
Januardi, J., Nasution, D., & Rahman, D. (2020). Hubungan faktor risiko lingkungan dengan peningkatan antibodi IgA anti-EBV pada KNF tipe III. Jurnal Biomedik dan Kesehatan, 12(1), 33–41.
Jayalie, D., Hutajulu, S. H., & Adham, M. (2016). Diagnosis dini karsinoma nasofaring berbasis biomarker serologis EBV. Jurnal Kedokteran Universitas Indonesia, 23(4), 215–222.
Kementerian Kesehatan Republik Indonesia (Kemenkes RI). (2019). Panduan Nasional Penanganan Kanker Nasofaring. Jakarta: Direktorat Pencegahan dan Pengendalian Penyakit Tidak Menular.
Li, H. P., Chang, Y. S., & Tsao, S. W. (2010). Epstein-Barr virus latent membrane protein 1 (LMP1) and its oncogenic role in nasopharyngeal carcinoma. Advances in Experimental Medicine and Biology, 659, 151–165.
Luderer, R., Kokowski, K., & Holzinger, D. (2005). Epstein-Barr virus latent infection and cancer development. Virology Journal, 2(1), 88–94.
Melani, S. (2012). Dasar patologi kanker kepala dan leher. Jakarta: EGC.
Munir, D. (2007). Epidemiologi karsinoma nasofaring di Sumatera Utara. Fakultas Kedokteran Universitas Sumatera Utara.
National Cancer Institute. (2009). Nasopharyngeal cancer treatment (PDQ®)–Patient version. National Institutes of Health (NIH). https://www.cancer.gov
Rahman, D., Farhat, M., & Nasution, D. (2018). Profil klinis dan serologi pasien karsinoma nasofaring di Padang. Jurnal Ilmu Kedokteran, 10(3), 191–199.
Rahman, D., Farhat, M., & Nasution, D. (2019). Kadar antibodi IgA anti-EA Epstein–Barr virus pada pasien karsinoma nasofaring di Padang. Jurnal Onkologi Indonesia, 12(2), 87–94.
Rao, D., Yu, X., & Sun, X. (2020). Serological screening for nasopharyngeal carcinoma: a review of EBV antibody detection. Cancer Epidemiology, 64, 101–109.
RS Kanker Dharmais. (2009). Laporan Tahunan Pusat Kanker Nasional RS Kanker Dharmais. Jakarta: Kementerian Kesehatan RI.
Shao, J. Y., et al. (2004). Epstein–Barr virus serologic profiles in the progression of nasopharyngeal carcinoma. Cancer Epidemiology, Biomarkers & Prevention, 13(11), 1974–1979.
Sihotang, R. (2014). Analisis peptida sintetik sebagai antigen alternatif untuk diagnosis KNF berbasis EBV. Jurnal Bioteknologi Medik Indonesia, 8(2), 63–72.
Sun, X., Li, Y., & Yu, X. (2015). Elevated serum IgA antibodies to EBV early antigen in patients with nasopharyngeal carcinoma in Shandong, China. Infectious Agents and Cancer, 10(1), 9–15.
Tedeschi, R., Bidoli, E., & Zanetti, R. (2007). Prognostic value of Epstein–Barr virus antibody levels in patients with nasopharyngeal carcinoma. Cancer, 109(8), 1645–1652.
Thompson, M. P. (2004). Epstein–Barr virus and cancer. Clinical Cancer Research, 10(3), 803–821.
WHO. (2014). World Cancer Report 2014. Lyon: International Agency for Research on Cancer (IARC).
Wu, L., Li, C., & Meng, D. (2018). Dietary factors and nasopharyngeal carcinoma risk: a case–control study in southern China. Nutrition and Cancer, 70(2), 229–237.
Xia, Y., Zhang, L., & Gao, Q. (2015). Diagnostic performance of EBV serological markers for screening nasopharyngeal carcinoma: a meta-analysis. PLoS ONE, 10(7), e0131027.
Zhou, X., Liu, F., & Wang, J. (2019). Association of age, gender, and Epstein–Barr virus antibody levels in nasopharyngeal carcinoma patients. Journal of Clinical Virology, 113, 19–25.
