Diagnostic significance of combined detection of Epstein-Barr virus antibodies, VCA/IgA, EA/IgA, Rta/IgG and EBNA1/IgA for nasopharyngeal carcinoma.

The objective of this study was to investigate the diagnostic significance of EBV antibody combined detection for nasopharyngeal carcinoma (NPC) in a high incidence region of southern China. Two hundred and eleven untreated NPC patients, 203 non-NPC ENT patients, and 210 healthy controls were recruited for the study. The titers of VCA/IgA and EA/IgA were assessed by immunoenzyme assay, and the levels of Rta/IgG and EBNA1/IgA were determined by enzyme-linked immunosorbent assay. The levels of VCA/IgA, EA/IgA, Rta/IgG and EBNA1/ IgA demonstrated no association with gender or age (p>0.05). The receiver operating characteristic curve and the area under the curve were used to evaluate the diagnostic value. The sensitivity of VCA/IgA (98.1%) and the specificity of EA/IgA (98.5%) were the highest. When a logistic regression model was used to combine the results from multiple antibodies to increase the accuracy, the combination of VCA/IgA+Rta/IgG, whose area under the curve was 0.99, had the highest diagnostic efficiency, and its sensitivity, specificity and Youden index were 94.8%, 98.0% and 0.93 respectively. The data suggest that the combination of VCA/IgA+Rta/IgG may be most suitable for NPC serodiagnosis.

[Prognostic significance of serum anti-Epstein-Barr virus antibodies in nasopharyngeal carcinoma].

OBJECTIVE: This study was aimed to investigate the association between serum against Epstein-Barr virus (EBV) antibodies levels and nasopharyngeal carcinoma (NPC) patients' prognosis. METHODS: Blood samples from 140 primary NPC patients without metastasis were collected before and after treatment. The titers of VCA/IgA and EA/IgA were detected by immunoenzyme assay, and the levels of NA1/IgA and Rta/IgG were detected by enzyme-linked immunosorbent assay (ELISA). All patients received consequent follow-up and long-term efficacy and survival assessment. RESULTS: Post-treatment serum levels of VCA/IgA, EA/IgA, NA1/IgA and Rta/IgG in NPC patients significantly decreased than those before treatment, while had significantly higher than those in control individuals (P < 0.05). Patients in remission had significantly lower pre-treatment serum levels of VCA/IgA and EA/IgA than patients with progression (P < 0.05). None of serum levels of VCA/IgA, EA/IgA, NA1/IgA and Rta/IgG was associated with the 3-year overall survival (P > 0.05). The progression-free survivals were significantly lower in patients with higher pre-treatment VCA/IgA (> or = 1 : 320) and EA/IgA (> or = 1:80) levels than in those with lower VCA/IgA ( < 1 : 320) and EA/IgA (< 1 : 80) levels, respectively (61.8% vs. 86.5% , 61.3% vs. 86.5%, P < 0.001). Cox regression model analysis demonstrated that pre-treatment serum VCA/IgA level was an independent risk factor for progression-free survival (HR = 3.80, P = 0.001). CONCLUSION: Anti-EBV VCA/IgA and EA/IgA might provide information regarding the prognosis of NPC patients.

[Combined detection of Epstein-Barr virus antibodies for serodiagnosis of nasopharyngeal carcinoma].

OBJECTIVE: To investigate the value of combined detection of Epstein-Barr virus (EBV) VCA/IgA, EA/IgA, Rta/IgG and EBNA1/IgA in serodiagnosis of nasopharyngeal carcinoma (NPC). METHODS: Serum samples obtained 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 and for Rta/IgG and EBNA1/IgA by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was generated to confirm the cutoff values of different antibodies. The evaluation indexes of combined detection of multiple antibodies used for serodiagnosis of NPC were calculated with compounded positive judgment method. RESULTS: Compared to a single antibody, combined detection achieved a higher sensitivity and specificity. The sensitivity of VCA/IgA + Rta/IgG + EBNA1/IgA (98.1%) was higher than the other 3 combinations with a specificity, accuracy, Youden index and positive predictive value (PPV) of 88.7%, 93.5%, 0.868 and 90.0%, respectively. The combination of EA/IgA+Rta/IgG+EBNA1/IgA had the highest specificity (95.1%), accuracy (94.9%), Youden index (0.899) and PPV (95.2%), with a sensitivity of 94.8%, suggesting its higher accuracy in the serodiagnosis of NPC. Combined detection of the 4 antibodies had the highest sensitivity (98.6%) with a specificity, accuracy, Youden index and PPV of 88.2%, 93.5%, 0.868 and 89.7%, respectively. CONCLUSIONS: Combined detection of Rta/IgG against immediate early antigens, EA/IgA against early antigens, VCA/IgA against late antigens, and EBNA1/IgA against latent antigens provides better understanding of the expression profiles of EBV lytic and latent antigens with excellent complementarity, and may serve as an optimal combination for NPC serodiagnosis.

[Evaluation of detection of Epstein-Barr virus Rta/IgG in nasopharyngeal carcinoma].

OBJECTIVE: This study was aimed to investigate the clinical value of Epstein-Barr virus (EBV) Rta/IgG in the diagnosis of nasopharyngeal carcinoma (NPC). METHODS: Serum samples derived from 211 untreated patients with NPC, 413 subjects including 203 non-NPC ENT patients and 210 healthy volunteers as control were examined for the presence of antibodies directed against Rta/IgG by using enzyme-linked immnunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was applied to perform methodical evaluation of this tumor marker. RESULTS: The rA value median of Rta/IgG in NPC group was significantly higher than one in control group (P < 0.001). The area under ROC was 0.933. The sensitivity and specificity of this marker were 90.5% and 90.1%, respectively, when the best cutoff value was defined. CONCLUSION: Rta/IgG detected with ELISA method is a new target of EBV, and may be one of important marker for NPC diagnosis.