Detection of IgA antibody to EBV membrane antigen using Staphylococcus aureus preabsorbed sera is closely associated with nasopharyngeal carcinoma.

The presence of IgA antibody to membrane antigen (MA) of Epstein-Barr virus (EBV) was tested in sera from 48 nasopharyngeal carcinoma (NPC) patients, 40 patients with tumors other than NPC and 46 normal individuals. The sera were preabsorbed with Staphylococcus aureus (SPA) (strain no. 1800) prior to their use in the indirect immunofluorescence test. One hundred percent of the NPC patients had the IgA/MA antibody with a GMT of 1:141. In patients with tumors other than NPC or normal individuals, IgA/MA antibodies were not detectable. The IgA/MA antibodies have been demonstrated in 6 NPC patients lacking detectable antibody levels in the indirect immunofluorescence test using nonabsorbed sera. Our data indicate that preabsorbtion of sera with SPA renders the diagnostic test significantly more sensitive for the detection of the nasopharyngeal carcinoma and can be used for trials on the prognosis of patients.

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.

Presence of EBV-DNA sequences in nasopharyngeal cells of individuals without IgA-VCA antibodies.

Exfoliated nasopharyngeal (NP) cells from 62 normal Cantonese Chinese having IgA/VCA antibodies for more than a year and from 39 similar persons without IgA/VCA antibodies, were tested for the presence of EBV/DNA sequences by spot followed by blot hybridization tests, using the cloned internal repeat of B95-8 viral DNA as probe. Thirteen out of 62 specimens from IgA/VCA-positive (21%) and six out of 39 specimens (15.4%) from IgA/VCA-negative individuals were found to contain EBV/DNA sequences. Forty-six cases (20 IgA/VCA-positive and 26 IgA/VCA-negative) were followed a year later for EBV/DNA sequences and EBV serology. Half of the individuals having EBV/DNA sequences in their exfoliated NP cells in 1981 did not have detectable EBV sequences a year later, and to out of 15 negative individuals became EBV/DNA-positive. There was no obvious correlation between EBV/DNA detectability and EBV serology. (We conclude that the best marker for NPC risk remains the increasing IgA/VCA and/or EA antibody titers.