Multiparametric Detection of Antibodies against Different EBV Antigens to Predict Risk for Nasopharyngeal Carcinoma in a High-Risk Population of China

In this study, we aimed to use the combined detection of multiple antibodies against EBV antigens to develop a model for screening and diagnosis of nasopharyngeal carcinoma (NPC). Samples of 300 NPC patients and 494 controls including 294 healthy subjects (HC), 99 non-NPC cancer patients (NNPC) and 101 patients with benign nasopharyngeal lesions (BNL) were incubated with the EUROLINE Anti-EBV Profile 2, and band intensities were used to establish a risk prediction model. The NPC risk probability analysis based on the panel of VCAgp125 IgA, EBNA-1 IgA, EA-D IgA, EBNA-1 IgG, EAD IgG and VCAp19 IgG displayed the best performance. When using 26.1% as the cut-off point in ROC analysis, the AUC value and sensitivity/specificity were 0.951 and 90.7%/86.2%, respectively, in NPC and all controls. In NPC and controls without the NNPC and BNL groups, the AUC value and sensitivity/specificity were 0.957 and 90.7%/88.1%, respectively. The diagnostic specificity and sensitivity of the EUROLINE Anti-EBV Profile 2 assay for both NPC and early-stage NPC were higher than that of mono-antibody detection by immune-enzymatic assay (IEA) and real-time PCR (EBV-DNA). In the VCA-IgA-negative group, 82.6% of NPC patients showed high probability for NPC and the negative predictive value (NPV) was 97.1%. In the VCA-IgA-positive group, 73.3% of healthy subjects showed low probability. The positive predictive value (PPV) reached 98.2% in this group. The NPC risk probability value determined by the EUROLINE Anti-EBV Profile 2 might be a suitable tool for NPC screening.

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