<p><b>OBJECTIVE</b>This study was aimed to investigate the diagnostic value of combined
determination of
Epstein-Barr virus (
EBV )
antibodies for
nasopharyngeal carcinoma (NPC), including
immunoglobulin (Ig) A against
EBV capsid antigens (VCA),
IgA against early
antigens (EA),
IgG against BRLF1 transcription activator (Rta) and
IgA against
EBV nuclear antigen -1 (EBNA1), assessed with
receiver operating characteristic (ROC) curve based on
logistic regression .</p><p><b>
METHODS </b>
Serum samples derived from 211 untreated
patients with NPC and 203 non-NPC ENT
patients were examined for the presence of VCA/
IgA and EA/
IgA by immunoenzymatic assay, Rta/
IgG and EBNA1/
IgA by
enzyme -linked immnunosorbent assay (
ELISA ). The different
Logistic regression models were established for various combined determinations of
antibodies , respectively. Using the predicted
probability as the analyzed variable,
ROC curve was applied to evaluate the diagnostic accuracy of different combined determinations.</p><p><b>RESULTS</b>The
sensitivity of VCA/
IgA (98.1%) and the
specificity of EA/
IgA (98.5%) were the highest while detecting solely. The results which were analyzed by
ROC curve based on
Logistic regression showed that the
sensitivity and specificity were improved. In two-marker combinations, VCA/
IgA + Rta/
IgG whose area under
ROC curve (
AUC ) was 0.991 had the highest diagnostic accuracy, and its
sensitivity ,
specificity and Youden index were 94.8%, 98.0% and 0.928 respectively. No significant difference of
AUC were found comparing VCA/
IgA + Rta/
IgG with VCA/
IgA + Rta/
IgG + EBNA1/
IgA and four-marker combination( P > 0.05), of which
sensitivity ,
specificity and Youden index were 94.8%, 98.5%, 0.933 and 96.7%, 97.0%, 0.937, respectively.</p><p><b>CONCLUSION</b>The approach of
ROC curve based on
Logistic regression can improve synthetic
efficiency for combined
determination of multiple markers. The combined
determination of VCA/
IgA and Rta/
IgG with a complementary effect is optimal for NPC
serodiagnosis .</p>