# Plasma EBV DNA

Source: https://onco.cc/terms/plasma-ebv-dna/  
OnCo record `plasma-ebv-dna` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Fragments of Epstein-Barr virus DNA in the blood that measure nasopharyngeal carcinoma: used to screen healthy people in endemic regions, to stage, to decide who needs extra treatment after radiotherapy, and to detect relapse.

## Summary

Quantitative PCR for EBV BamHI-W or EBNA1 sequences in plasma (Lo, 1999) correlates with tumour burden and stage in EBV-associated NPC. Uses: (1) screening: a two-stage plasma EBV DNA test in 20,174 Hong Kong men detected NPC at earlier stage with better survival (Chan, NEJM 2017); (2) prognosis: pretreatment level is independent of TNM and incorporated in proposed staging; (3) response: detectable EBV DNA after chemoradiation identifies high-risk patients who benefit from adjuvant chemotherapy (NRG-HN001 trial design; Chen 2021 capecitabine); (4) surveillance: rising levels precede clinical relapse by months. Standardisation across laboratories (harmonised assays) remains a challenge; NGS-based fragmentomic assays improve specificity. It is the template for ctHPV DNA in oropharyngeal cancer.

## Fields

- Kind: Term
- Last checked: 2026-09-08
- Tags: gap-fill; biomarker

## Notes

- Lymphoma: what a plasma EBV DNA level means depends on which latency programme the tumour is running, because that decides how much viral DNA is shed and how visible the cell is to T cells. It is used to follow response in extranodal NK/T-cell lymphoma and in post-transplant lymphoproliferative disorder, where reducing immunosuppression is the first treatment (Young and Rickinson 2004).

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Epstein-Barr_virus
- Chan 2017 screening (NEJM): https://doi.org/10.1056/NEJMoa1701717
- Young and Rickinson, Nat Rev Cancer 2004: Epstein-Barr virus, 40 years on: https://doi.org/10.1038/nrc1452

## Connected records

- cancers: [Extranodal NK/T-cell lymphoma](https://onco.cc/cancers/extranodal-nk-t-cell-lymphoma/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [Locoregionally advanced nasopharyngeal carcinoma (stage III to IVA)](https://onco.cc/cancers/locoregionally-advanced-nasopharyngeal-carcinoma/), [Nasopharyngeal carcinoma](https://onco.cc/cancers/nasopharyngeal/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/), [Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)](https://onco.cc/cancers/peripheral-t-cell-lymphoma/), [Post-transplant lymphoproliferative disorder (PTLD)](https://onco.cc/cancers/post-transplant-lymphoproliferative-disorder/), [Recurrent and metastatic nasopharyngeal carcinoma](https://onco.cc/cancers/recurrent-metastatic-nasopharyngeal-carcinoma/)
- technologies: [Circulating tumour HPV DNA (ctHPV-DNA)](https://onco.cc/technologies/cthpv-dna/), [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/)
- terms: [Circulating tumour DNA (ctDNA)](https://onco.cc/terms/ctdna/), [Epstein-Barr virus (EBV) in cancer](https://onco.cc/terms/ebv-term/), [Epstein-Barr virus latency programmes, and why they decide which lymphoma](https://onco.cc/terms/lymphoma-bio-ebv-latency/), [Head and neck subsites (oral cavity, oropharynx, larynx)](https://onco.cc/terms/head-neck-subsites/)
- institutions: [Prince of Wales Hospital / Chinese University of Hong Kong](https://onco.cc/institutions/prince-of-wales-hospital-cuhk/), [Queen Mary Hospital / University of Hong Kong](https://onco.cc/institutions/queen-mary-hospital-hku/), [Sun Yat-sen University Cancer Center](https://onco.cc/institutions/sysucc/)
- key papers: [Analysis of Plasma Epstein-Barr Virus DNA to Screen for Nasopharyngeal Cancer](https://onco.cc/key-papers/paper-chan-n-engl-j-med/)
- pathways: [Oncogenic viruses](https://onco.cc/pathways/oncogenic-viruses/)

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