Immunohistochemical and Molecular Detection of Keratin, Epithelial Membrane Antigen, Cytomegalovirus, Epstein Barr Virus and Herpes Simplex Virus among Sudanese Patients with Nasopharyngeal Carcinoma

Abstract

This retrospective perspective study was conducted in Radiation and Isotope Center Khartoum (RICK), during the period from June 2012 to December 2014. This study aimed to detectimmunoexpression of keratin(CK) and epithelial membrane antigen(EMA) among Sudanesepatients with nasopharyngeal carcinoma and detection of Cytomegalovirus(CMV), Epstein Barr Virus(EBV) and Herpes Simplex Virus(HSV). patients ages ranged between 17 to 88 years with a mean age of 50 years. Most patients were older than the age of 50 years representing 77 (51.3%) and the remaining 73(48.7%) were younger than50 years)97(64.7%) of study subjects were males. While, 53 (35.3%) of study subjects were females.All samples were stained with hematoxylin and eosin to confirm histopathologicaldiagnosis, immunohistochemichemistry (avidin biotin) for detection of CK and EMA Cytokeratinstumer marker . Molecular technique (PCR)for detection of EBV, CMV,and HSV.The relationship between CK and EMA and these viruses were showed as followCK expression was demonstrated in 150 samples, 144/150(96%) were CK positive and the remaining 6/150(4%) were CK negative (internal control). CK and EBV correlation was identified in 92/144(64%). CK and CMV correlation was identified in 53/144(37%). CK and HSV correlation was identified in 18/144(12.5%) for immune-expression of EMP2 and molecular identification of herpes viruses (EBV=92, CMV=53 and HSV=18) correlations. loss of EMP2 (negative) was identified in 10/92 and the remaining 82/92were positive. 53 positive CMV loss of EMP2 (negative) was identified in 10/53 and the remaining 43/53were positive. Out of the 18 positive HSV loss of EMP2 (negative) was identified in 4/18 (22.2%) and the remaining 14/18(77.8%) were positive. Furthermore, 26 EMA negative were found HSV negative, consequently, EMA expression was demonstrated by immunohistochemistry using EMA antibodies. EBV, CMV and HSV were identified by polymerase chain Reaction (PCR) and the results were showed s follow : loss of EMA (negative) was identified in 10.9%, 18.9%, and22.2%, of EBV, CMV and HSV, respectively. This study concluded that : In NPC, there is significant correlation between loss of expression of EMA and human herpes viruses (EBV, CMV and HSV). The study found that there is strong correlation between Herpes viruses EBV and CMV and cytokeratin expression in NPC but not HSV. Knowledge of the exact interaction between cytokeratins and these viruses may stimulate new ideas that help in prognosis, treatment and overall management of patients with NPC.There was a high loss of EMA in NPC, which is corresponding to high NPC types. Loss of CK expression is relatively linked to high NPC types. Further studies to highlight the biological interrelation between theses markers and NPC is deemed necessary. However, and to the best of our knowledge no study have investigated the exact interaction (s) between EMA and Herpes viruses. So this study is a stimulation for further research in this area. The study recommended more surveys for the work of communities of patients using more immunohistchemistry with more markers to study the relationship with nasopharyngeal carcinoma in most advanced molecular techniques to confirm the role of the this special stains and technique in the development of nasopharyngeal cancer in the Sudan.