Department of Clinical Laboratory, Fujian Provincial Key Laboratory of Tumor Biotherapy, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No. 420 Fuma Road, 350014, Fuzhou City, Fujian Province, China.
Pathol Oncol Res. 2020 Oct;26(4):2185-2190. doi: 10.1007/s12253-020-00808-0. Epub 2020 Mar 28.
Epstein-Barr virus (EBV)-based serologic antibody testing has been found to be a feasible alternative for nasopharyngeal carcinoma (NPC) screening in endemic areas. The purpose of this study was to evaluate the performance of ELISA based on VCA IgA antibody, EA-IgA and Rta-IgG antibody specific to EBV in the diagnosis of NPC. A total of 2155 untreated NPC patients and 6957 healthy volunteers without nasopharyngeal disorder were recruited, and all subjects received EBV VCA-IgA, EA-IgA and Rta-IgG antibody tests simultaneously. The diagnostic efficiency of three testing alone or in combination for the diagnosis of NPC was evaluated. The prevalence of IgA antibody against EBV-VCA, IgA antibody against EBV-EA and IgG antibody against EBV-Rta was 89.9%, 46.6% and 63.2%. The sensitivity, specificity, positive predictive value, negative predictive value and Youden index were 89.88%, 89.65%, 73.18%, 96.63% and 0.79 for the EBV VCA-IgA antibody test, 46.59%, 96.89%, 82.5%, 85.42% and 0.43 for the EA-IgA antibody test, and 63.25%, 94.87%, 79.48%, 89.29% and 0.58 for the Rta-IgG antibody test in the diagnosis of NPC, and ROC curve analysis revealed the greatest diagnostic efficiency for EBV VCA-IgA antibody test and the lowest efficiency for EBV EA-IgA antibody test in the diagnosis of NPC. In addition, the simultaneous triple positivity of VCA-IgA, EA-IgA and Rta-IgG antibodies specific to EBV indicated the highest risk of NPC, and the simultaneous triple negativity of the three types of anti-EBV antibodies suggested the lowest risk of NPC. Our data demonstrate that EBV VCA-IgA antibody test shows a higher diagnostic efficiency than EA-IgA and Rta-IgG antibody tests for the screening of NPC, and triple positivity of is a better biomarker for the diagnosis of NPC.
EBV 血清学抗体检测已被证明是流行地区鼻咽癌（NPC）筛查的一种可行替代方法。本研究旨在评估基于 EBV VCA IgA 抗体、EA-IgA 和 Rta-IgG 抗体的 ELISA 在 NPC 诊断中的性能。共招募了 2155 例未经治疗的 NPC 患者和 6957 例无鼻咽疾病的健康志愿者，所有受试者同时接受 EBV VCA-IgA、EA-IgA 和 Rta-IgG 抗体检测。评估了三种检测方法单独或联合用于 NPC 诊断的诊断效率。三种检测方法单独或联合用于 NPC 诊断的灵敏度、特异性、阳性预测值、阴性预测值和 Youden 指数分别为 EBV VCA-IgA 抗体检测的 89.88%、89.65%、73.18%、96.63%和 0.79，EA-IgA 抗体检测的 46.59%、96.89%、82.5%、85.42%和 0.43，Rta-IgG 抗体检测的 63.25%、94.87%、79.48%、89.29%和 0.58。ROC 曲线分析显示，在 NPC 诊断中 EBV VCA-IgA 抗体检测具有最高的诊断效率，而 EBV EA-IgA 抗体检测的效率最低。此外，EBV 特异性 VCA-IgA、EA-IgA 和 Rta-IgG 抗体的同时三重阳性提示 NPC 风险最高，而三种 EBV 抗体同时三重阴性提示 NPC 风险最低。我们的数据表明，EBV VCA-IgA 抗体检测在 NPC 筛查中比 EA-IgA 和 Rta-IgG 抗体检测具有更高的诊断效率，三重阳性是 NPC 诊断的更好生物标志物。
