title: Enhancing the efficiency of Epstein-Barr viral serologic test in the diagnosis of nasopharyngeal carcinoma.
abstract: OBJECTIVE
  To investigate the efficiency of concurrent application of VCA-IgA, EA-IgA and EA-IgG serological tests in diagnosing nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  The sera of 266 untreated NPC patients and 347 healthy adults were collected. In addition to the conventional immunoenzymatic method of VCA-IgA test, enzyme-linked immunosorbent assay (ELISA) was adopted as an alternative to test the antibody level of EA-IgG and EA-IgA. A new statistical formula was used to evaluate the odds ratio of different combinations of these three tests.
  
  
  RESULTS
  The sensitivity and specificity of VCA-IgA, EA-IgG and EA-IgA concurrently were as high as 95.11% and 97.41%, respectively, which were higher than those of single test (90.60% and 94.52% for VCA-IgA, 93.98% and 93.66% for EA-IgG, 89.84% and 88.18% for EA-IgA). Furthermore, the odds ratio of 3-test positivity (1 912.5) was higher than those of 2-test positivity (27.903 2 for VCA-IgA and EA-IgG, 11.169 0 for EA-IgG and EA-IgA, 8.032 8 for VCA-IgA and EA-IgA), which were even higher than those of 1-test positivity (0.121 4 for VCA-IgA, 0.170 5 for EA-IgG and 0.048 8 for EA-IgA).
  
  
  CONCLUSIONS
  ELISA is more accurate in reflecting the antibody level of EA-IgG and EA-IgA than the conventional immunoenzymatic method. The concurrent application of VCA-IgA, EA-IgG and EA-IgA test can markedly improve the sensitivity, specificity and odds ratio as well, thus resulting in enhancing the efficiency of diagnosing nasopharyngeal carcinoma serologically.
authors.affiliation: Cancer Hospital, Sun Yat-sen University, Guangzhou, 510060, China.
authors.forename: Changqing
authors.initials: C
authors.lastname: Zhang
authors.forename: Yongsheng
authors.initials: Y
authors.lastname: Zong
authors.forename: Baozhen
authors.initials: B
authors.lastname: Huang
authors.forename: Yun
authors.initials: Y
authors.lastname: Sun
authors.forename: Yongzhao
authors.initials: Y
authors.lastname: Ye
authors.forename: Kaitao
authors.initials: K
authors.lastname: Feng
authors.forename: Jinglue
authors.initials: J
authors.lastname: Li
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D000956:Antigens, Viral / Q000276:immunology*; D036022:Capsid Proteins / Q000276:immunology*; D003951:Diagnostic Errors; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D009303:Nasopharyngeal Neoplasms / Q000097:blood / Q000276:immunology / Q000821:virology*; D012680:Sensitivity and Specificity; D012698:Serologic Tests
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D036022:Capsid Proteins; C041788:Epstein-Barr viral capsid antigen; C033305:Epstein-Barr virus early antigen; D007070:Immunoglobulin A