Diagnostic value of Epstein-Barr viral serology in nasopharyngeal carcinoma

Although Epstein-Barr virus (EBV) IgA serology has been established as an effective marker for nasopharyngeal carcinoma (NPC), it remains unclear how useful or cost-effective it is as a screening test. This article is aimed at establishing how these tests could be used most effectively in the diagno...

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Published in:Otolaryngology-head and neck surgery 2000-10, Vol.123 (4), p.505-507
Main Authors: Low, Wong-Kein, Leong, Jern-Lin, Goh, Yau-Hong, Fong, Kam-Weng
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnosis
Adenocarcinoma - virology
Adult
Aged
Biomarkers - analysis
Epstein-Barr Virus Infections - diagnosis
Epstein-Barr Virus Infections - epidemiology
Epstein-Barr Virus Nuclear Antigens - analysis
Female
Herpesvirus 4, Human - isolation & purification
Humans
Male
Mass Screening - methods
Middle Aged
Nasopharyngeal Neoplasms - diagnosis
Nasopharyngeal Neoplasms - virology
Sensitivity and Specificity
Serologic Tests
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Summary:Although Epstein-Barr virus (EBV) IgA serology has been established as an effective marker for nasopharyngeal carcinoma (NPC), it remains unclear how useful or cost-effective it is as a screening test. This article is aimed at establishing how these tests could be used most effectively in the diagnosis of NPC in an otolaryngology outpatient clinic. A total of 111 consecutive patients with NPC and an equal number of control subjects were studied. Forty-seven patients with NPC had early (AJCC stages 1 and 2) and 64 had advanced (stages 3 and 4) disease. A positive early antigen (EA) serology result was found in 81.2% of NPC patients and in none of the controls. Negative EA and viral capsid antigen (VCA) serology results were present in 2.7% of NPC patients and in 46.8% of controls. Negative EA and positive VCA serology results were found in 30.0% of NPC patients with early disease, 7.8% of NPC patients with advanced disease, and 53.2% of controls. Given its high specificity, serology for EA is recommended as a clinically useful screening test. Serology for VCA, although highly sensitive, has an unacceptably high false-positive rate, and its cost-effectiveness as a universal screening test is questionable. (Otolaryngol Head Neck Surg 2000;123:505-7.)
ISSN:0194-5998
1097-6817
DOI:10.1067/mhn.2000.108201