Circulating Epstein‒Barr virus microRNA BART8-3p as a potential biomarker for detection and prognostic prediction in early nasopharyngeal carcinoma

Abstract Backgroud To evaluate the clinical significance of plasma Epstein‒Barr virus (EBV) BamHI A rightward transcript (BART)-encoded microRNA 8-3p (miR-BART8-3p) in patients with early nasopharyngeal carcinoma (NPC). Methods A total of 126 patients with stage I and II NPC were retrospectively analysed. A receiver operating characteristic curve (ROC) was used to examine the diagnostic performance. Kaplan‒Meier analysis was applied to determine survival. Cox regression was used for univariate and multivariate analyses. Results The sensitivity, specificity and area under the curve (AUC) value of plasma miR-BART8-3p alone in the detection of early NPC were 69.0%, 97.2% and 0.826, respectively, and the corresponding rate was up to 88.9%, 94.4% and 0.931 when miR-BART8-3p was combined with EBV DNA. Compared to patients with low expression of miR-BART8-3p, patients with high expression of miR-BART8-3p had significantly shorter overall survival (OS), locoregional recurrence-free survival (LRRFS) and distant metastasis-free survival (DMFS). High-risk patients (with both high miR-BART8-3p and high EBV DNA) had inferior OS, LRRFS and DMFS than low-risk patients (neither high EBV DNA nor high miR-BART8-3p) ( P < 0.05). Multivariate analysis verified that the high-risk group was an unfavorable factor for OS (HR = 18.39; 95% CI 1.53-221.69; P = 0.022) and DMFS (HR = 21.06; 95% CI, 2.30-192.75; P = 0.007). A nomogram based on miR-BART8-3p could better predict patients' metastatic probability. Conclusion Circulating miR-BART8-3p is a potential biomarker for detection and prognostic prediction in early NPC. Future clinical trials are needed to confirm and develop personalized and precise strategies for those patients.