title: Sensitivity and specificity of Epstein-Barr virus IGA titer in the diagnosis of nasopharyngeal carcinoma: a three-year institutional review.
abstract: BACKGROUND
  IgA antibody titers to the Epstein-Barr virus (EBV) viral capsid antigen (EBV IgA-VCA) and to the EBV early antigen (EBV IgA-EA) are used to screen for nasopharyngeal carcinoma (NPC). This study evaluates the sensitivity and specificity of EBV IgA-VCA and EBV IgA-EA titers in screening patients for NPC and in those diagnosed with NPC at our institution.
  
  
  METHODS
  The NPC status was determined for all patients who had their EBV IgA-VCA and EBV-IgA EA titers measured over a 3-year period, and the sensitivity and specificity were calculated.
  
  
  RESULTS
  Five thousand one hundred ninety-six samples were analyzed. NPC was diagnosed in 215 patients. The sensitivity and specificity of a raised EBV IgA-VCA titer (> or =1:5) for diagnosing NPC were 89% and 80%, respectively, with a raised EbV IgA-EA titer (> or =1:5) having a sensitivity and specificity of 63% and 97%, respectively.
  
  
  CONCLUSIONS
  Although the EBV IgA-VCA titer is sensitive for the diagnosis of NPC, it should not be used as the sole means of screening for NPC in a population in which NPC is endemic.
authors.affiliation: Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR.
authors.forename: Raymond K Y
authors.initials: RK
authors.lastname: Tsang
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Vlantis
authors.forename: Ricky W K
authors.initials: RW
authors.lastname: Ho
authors.forename: John S L
authors.initials: JS
authors.lastname: Tam
authors.forename: K F
authors.initials: KF
authors.lastname: To
authors.forename: C Andrew
authors.initials: CA
authors.lastname: van Hasselt
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000276:immunology*; D014408:Biomarkers, Tumor / Q000097:blood; D002213:Capsid / Q000276:immunology*; D036022:Capsid Proteins / Q000276:immunology*; D004854:Herpesvirus 4, Human; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D009302:Nasopharyngeal Diseases / Q000175:diagnosis* / Q000821:virology; D012680:Sensitivity and Specificity
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D014408:Biomarkers, Tumor; D036022:Capsid Proteins; C041788:Epstein-Barr viral capsid antigen; C033305:Epstein-Barr virus early antigen; D007070:Immunoglobulin A