Clinical characteristics and prognostic significance of EBER positivity in diffuse large B-cell lymphoma: A meta-analysis

• Published in: PloS one Vol. 13; no. 6; p. e0199398
• Main Authors: Gao, Xiaojuan, Li, Jia, Wang, Yaqi, Liu, Shuai, Yue, Baohong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.06.2018; Public Library of Science (PLoS)
• Subjects: B cells; B-cell lymphoma; Biology and life sciences; Cancer; Care and treatment; Cell cycle; Chemotherapy; Coding; Confidence intervals; Correlation; Diagnosis; Disease-Free Survival; Epstein-Barr virus; Herpesvirus 4, Human - genetics; Herpesvirus 4, Human - isolation & purification; Herpesvirus 4, Human - pathogenicity; Humans; L-Lactate dehydrogenase; Laboratories; Lactate dehydrogenase; Lactic acid; Lymphocytes B; Lymphoma; Lymphoma, Large B-Cell, Diffuse - epidemiology; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Large B-Cell, Diffuse - virology; Medical prognosis; Medicine; Medicine and health sciences; Meta-analysis; Non-Hodgkin's lymphomas; Patients; People and Places; Physical Sciences; Prognosis; Research and Analysis Methods; RNA, Viral - genetics; RNA, Viral - isolation & purification; Studies; Survival; Viruses; China; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0199398

Recent studies show that Epstein-Barr virus (EBV) positivity might be related to adverse prognosis in patients with diffuse large B-cell lymphoma (DLBCL), but the results are still inconclusive. We conducted this meta-analysis to define the clinical value of EBV infection in DLBCL. All potential articles in PubMed, Web of Science, Medline, and Embase were retrieved. Using the random-effects or fixed-effect model, pooled hazard ratios (HRs) or relative risk (RR) with 95% confidence intervals (CIs) were used to calculate the correlation between EBER and prognosis and clinical features in DLBCL. A total of 13 qualified studies with 4111 patients were identified in our meta-analysis based on the inclusion and exclusion criteria. The overall estimates revealed that EBV-encoded small RNAs (EBER) positivity was significantly correlated with worse overall survival (HR = 2.43, 95% CI: 1.73-3.36) and progression-free survival (HR = 3.60, 95% CI: 2.07-6.26). In addition, EBER positivity was associated with age older than 60 years (RR = 1.51, 95% CI: 1.02-2.24), male sex (RR = 1.34, 95% CI: 1.05-1.71), more advanced stage (RR = 2.25, 95% CI: 1.72-2.96), high international prognostic index (RR = 2.20, 95% CI: 1.71-2.82), more than one extranodal involvement (RR = 1.69, 95% CI: 1.27-2.26), presence of B symptom (RR = 1.75, 95% CI: 1.30-2.35), non-germinal center B-cell subtype (RR = 1.35, 95% CI: 1.03-1.78), and elevated lactate dehydrogenase levels (RR = 1.30, 95% CI: 0.98-1.72). EBER positivity was correlated with worse outcomes, worse clinical course, and adverse clinicopathologic features among patients with DLBCL.