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 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.
Low
W K
WK
Department of Otolaryngology, Singapore General Hospital, Singapore.
Leong
J L
JL
Goh
Y H
YH
Fong
K W
KW
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000821:virology*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000453:epidemiology; D019309:Epstein-Barr Virus Nuclear Antigens / Q000032:analysis; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000821:virology*; D012680:Sensitivity and Specificity; D012698:Serologic Tests
D015415:Biomarkers; D019309:Epstein-Barr Virus Nuclear Antigens