Comparison of Epstein-Barr Virus Serological Tools for the Screening and Risk Assessment of Nasopharyngeal Carcinoma: a Large Population-based Study.

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.

Serological and immunohistological assessment of Epstein-Barr virus infection in Sicilian patients with suspected nasopharyngeal carcinoma.

An evaluation of antibodies to Epstein-Barr virus (EBV) was carried out on 18 patients with suspected nasopharyngeal carcinoma (NPC). With one exception, 9 patients, with histologically confirmed NPC, had high levels of IgG and IgA antibodies to EBV-related antigens, VCA and EA. Out of 4 patients, without histologically confirmed NPC and an antibody pattern compatible with the disease, one developed NPC 22 months later. These data confirm the usefulness of serological markers as a diagnostic aid in NPC and indicate that the occurrence of this malignancy might be higher in Sicily than in low-risk zones.

[Strict correlation between anti-RANA antibodies and anti-EBNA antibodies apart from rheumatoid arthritis. Assessment of the diagnostic value of anti-RANA antibody]. / Corrélation étroite entre l'anticorps anti-RANA et l'anticorps anti-EBNA en dehors de la polyarthrite rhumatoïde. Critique de la valeur diagnostique de l'anticorps anti-RANA.

In order to study the relationship between anti-RANA antibodies (aRANA) and the antibodies capable of recognising other Epstein-Barr induced antigens, we examined the sera of 51 patients without rheumatoid arthritis for anti-RANA, anti-EA, anti-VCA, and anti-EBNA antibodies. These subjects were cases of Burkitt's lymphoma, infectious mononucleosis, naso-pharyngeal carcinoma, immune disorders, Hodgkin's disease and normal controls. A blind study was conducted in two separate laboratories. Anti-RANA was detected by indirect immunofluorescence on RAJI cells synchronised in phase G1. There was a very strict correlation between anti-RANA and anti-EBNA with no correlation between anti-RANA and anti-EA or anti-VCA. In another experiment, 15 coded sera from patients with classical rheumatoid arthritis were tested following adsorption of the rheumatoid factor. One serum was found to be devoid of both anti-RANA and anti-EBNA. These results demonstrate that anti-RANA is widely distributed outside of rheumatoid arthritis and they question the distinction between EBNA and RANA, as the antibody titres directed against these antigens are regularly linked together.

Immunovirologic assessment of American patients with nasopharyngeal carcinoma and occult primary tumors.

The Epstein-Barr virus (EBV) is closely associated with nasopharyngeal carcinoma, suggesting an etiologic relationship. We have under-taken studies (1) to quantitate the relationship between antibody titers to EBV-associated antigens and nasopharyngeal carcinoma in American patients since most of the patients in previous studies were of either Asian or African descent and (2) to determine the relationship between antibody titers and the clinical course of the disease. Sera from patients with primary or recurrent nasopharyngeal carcinoma and from patients in remission, from patients with various other head and neck tumors (including occult primary lesions and lymphomas), and from normal controls were titrated for IgG antibodies to viral capsid antigen (VCA) and early antigen and IgA antibodies to VCA, using indirect immunofluorescence procedures previously detailed. High titers of antibodies to EBV-induced early antigens and VCA in the IgG fraction and VCA in the IgA fraction were frequently found in the sera of patients with nasopharyngeal carcinoma. A significant reduction in these titers was observed with clinical remission of the disease in treated patients. Preliminary findings suggest that EBV serology may be useful in the evaluation and treatment of patients with nasopharyngeal carcinoma and also in patients with cervical metastases from clinically occult promary sites in order to identify those with occult nasopharyngeal carcinoma.