The serological diagnostic value of EBV-related IgA antibody panels for nasopharyngeal carcinoma: a diagnostic test accuracy meta-analysis

• Published in: BMC cancer 2024-09, Vol.24 (1), p.1115-9, Article 1115
• Main Authors: Liu, Han, Lei, Lin, Song, Song, Geng, Xianyi, Lin, Kaihao, Li, Ni, Chen, Wanqing, Peng, Ji, Ren, Jiansong
• Format: Article
• Language: English
• Subjects: Accuracy; Analysis; Antibodies; Antibodies, Viral - blood; Antibodies, Viral - immunology; Bias; Biomarkers; Biomarkers, Tumor - blood; Biomarkers, Tumor - immunology; Cancer; Carcinoma; Care and treatment; Control; Diagnosis; Diagnostic tests; Early detection; Early Detection of Cancer - methods; Enzyme-linked immunosorbent assay; Epstein-Barr virus; Epstein-Barr Virus Infections - blood; Epstein-Barr Virus Infections - complications; Epstein-Barr Virus Infections - diagnosis; Epstein-Barr Virus Infections - immunology; Epstein-Barr Virus Nuclear Antigens - immunology; Health aspects; Herpesvirus 4, Human - immunology; Humans; Identification and classification; IgA; Immunoglobulin A; Immunoglobulin A - blood; Immunoglobulin A - immunology; Immunoglobulin G; Measurement; Medical research; Medical screening; Medical tests; Meta-analysis; Nasopharyngeal cancer; Nasopharyngeal carcinoma; Nasopharyngeal Carcinoma - blood; Nasopharyngeal Carcinoma - diagnosis; Nasopharyngeal Carcinoma - immunology; Nasopharyngeal Carcinoma - virology; Nasopharyngeal Neoplasms - blood; Nasopharyngeal Neoplasms - diagnosis; Nasopharyngeal Neoplasms - immunology; Nasopharyngeal Neoplasms - virology; Online databases; Patients; Prognosis; Quality control; Regression analysis; Screening; Sensitivity analysis; Sensitivity and Specificity; Serologic Tests - methods; Serology; Serum; Statistical analysis; Statistical models
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-12878-3

Nasopharyngeal carcinoma (NPC) is diagnosed relatively late and has a poor prognosis, requiring early detection to reduce the disease burden. This diagnostic test accuracy meta-analysis evaluated the serological diagnostic value of nine EBV-related IgA antibody panels (EBNA1-IgA, VCA-IgA, EA-IgA, Zta-IgA, EBNA1-IgA + VCA-IgA, VCA-IgA + EA-IgA, VCA-IgA + Rta-IgG, EBNA1-IgA + VCA-IgA + Zta-IgA and VCA-IgA + EA-IgA + Rta-IgG), aiming to identify suitable serological detection biomarkers for NPC screening. PubMed, Embase, China National Knowledge Infrastructure and Chinese BioMedical Literature Database were searched from January 1st, 2000 to September 30th, 2023, with keywords nasopharyngeal carcinoma, IgA, screening, early detection, early diagnosis, sensitivity and specificity. Articles on the diagnostic value of serum EBV-related IgA antibody panels for NPC were included. Study selection, data extraction, and quality assessment were performed independently by two researchers, and a third researcher was consulted in the case of disagreement. Bivariate models were used for statistical analysis. The quality of included studies was evaluated through Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). A total of 70 articles were included, involving 11 863 NPC cases and 34 995 controls. Among the nine EBV-related IgA antibody panels, EBNA1-IgA + VCA-IgA [0.928 (0.898, 0.950)], VCA-IgA + Rta-IgG [0.925 (0.890, 0.949)], EBNA1-IgA + VCA-IgA + Zta-IgA [0.962 (0.909, 0.985)] and VCA-IgA + EA-IgA + Rta-IgG [0.945 (0.918, 0.964)] demonstrated higher pooled sensitivity (95%CI). In terms of diagnostic odds ratio (DOR) (95%CI), EBNA1-IgA + VCA-IgA [107.647 (61.173, 189.430)], VCA-IgA + Rta-IgG [105.988 (60.118, 186.857)] and EBNA1-IgA + VCA-IgA + Zta-IgA [344.450 (136.351, 870.153)] showed superior performance. Additionally, the SROC curves for EBNA1-IgA + VCA-IgA and VCA-IgA + Rta-IgG were more favorable. However, publication bias was detected for VCA-IgA (P = 0.005) and EBNA1-IgA + VCA-IgA (P = 0.042). In general, parallel detection of serum EBNA1-IgA, VCA-IgA and Zta-IgA antibodies using ELISA demonstrates better pooled sensitivity and DOR among the studied panels. In the cases where fewer indicators are used, serum VCA-IgA and EBNA1-IgA/Rta-IgG antibody panel exhibits a comparable performance. The International Prospective Register of Systematic Reviews registration number: CRD42023426984, registered on May 28, 2023.