Epstein-Barr virus seroepidemiology in China.

Since 1978 more than 300,000 sera from normal individuals were screened serologically in NPC high risk areas and prospective studies were carried out. Many patients were diagnosed in early stage. For example, in Wuzhou city, 20,726 persons over 40 years of age were screened; 1,138 persons were found to have IgA VCA antibody. Among them 18 NPC cases were detected; an additional 21 NPC patients were found within 5 year follow-up studies. Altogether there were 39 NPC patients. As compared to the patients in outpatient clinics, the frequency of NPC in stage I increased from 1.7% to 38.5% and in early stage (I + II) increased from 32% to 92.3%. IgA VCA antibody can be detected 5 years before the diagnosis of NPC in early stage was made. The detection rate of NPC from IgA VCA antibody-positive persons is 38-374 times the incidence rate of NPC in the general population of the same age group. Follow-up studies on the change of IgA VCA antibody titer in antibody-positive and antibody-negative groups were also carried out for years. 10.9% of antibody-positive individuals became antibody negative and 5.4% seronegative persons converted to positive within 4 years. Eighty-eight per cent of NPC patients were detected in the group of no change of antibody titer or in the group of increasing antibody titer. No NPC patients were found in the original antibody negative group.