title: Autoantibody Signatures Combined with Epstein-Barr Virus Capsid Antigen-IgA as a Biomarker Panel for the Detection of Nasopharyngeal Carcinoma.
abstract: Nasopharyngeal carcinoma (NPC) is prevalent in Southern China and Southeast Asia, and autoantibody signatures may improve early detection of NPC. In this study, serum levels of autoantibodies against a panel of six tumor-associated antigens (p53, NY-ESO-1, MMP-7, Hsp70, Prx VI, and Bmi-1) and Epstein-Barr virus capsid antigen-IgA (VCA-IgA) were tested by enzyme-linked immunosorbent assay in a training set (220 NPC patients and 150 controls) and validated in a validation set (90 NPC patients and 68 controls). We used receiver-operating characteristics (ROC) to calculate diagnostic accuracy. ROC curves showed that use of these 6 autoantibody assays provided an area under curve (AUC) of 0.855 [95% confidence interval (CI), 0.818-0.892], 68.2% sensitivity, and 90.0% specificity in the training set and an AUC of 0.873 (95% CI, 0.821-0.925), 62.2% sensitivity, and 91.2% specificity in the validation set. Moreover, the autoantibody panel maintained diagnostic accuracy for VCA-IgA-negative NPC patients [0.854 (0.809-0.899), 67.8%, and 90.0% in the training set; 0.879 (0.815-0.942), 67.4%, and 91.2% in the validation set]. Importantly, combination of the autoantibody panel and VCA-IgA improved diagnostic accuracy for NPC versus controls compared with the autoantibody panel alone [0.911 (0.881-0.940), 81.4%, and 90.0% in the training set; 0.919 (0.878-0.959), 78.9%, and 91.2% in the validation set), as well as for early-stage NPC (0.944 (0.894-0.994), 87.9%, and 94.0% in the training set; 0.922 (0.808-1.000), 80.0%, and 92.6% in the validation set]. These results reveal autoantibody signatures in an optimized panel that could improve the identification of VCA-IgA-negative NPC patients, may aid screening and diagnosis of NPC, especially when combined with VCA-IgA.
authors.affiliation: Department of Clinical Laboratory, the Cancer Hospital of Shantou University Medical College, Guangdong, China. The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Guangdong, China.
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Peng
authors.affiliation: Department of Clinical Laboratory, the Cancer Hospital of Shantou University Medical College, Guangdong, China. The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Guangdong, China. Institute of Oncologic Pathology, Shantou University Medical College, Guangdong, China.
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Xu
authors.affiliation: Department of Radiation Oncology, the Cancer Hospital of Shantou University Medical College, Guangdong, China.
authors.forename: Li-Sheng
authors.initials: LS
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, the Cancer Hospital of Shantou University Medical College, Guangdong, China.
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Zhai
authors.affiliation: Department of Biochemistry and Molecular Biology, Shantou University Medical College, Guangdong, China.
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Dai
authors.affiliation: The Breast Center, the Cancer Hospital of Shantou University Medical College, Guangdong, China.
authors.forename: Si-Qi
authors.initials: SQ
authors.lastname: Qiu
authors.affiliation: Record Room, the Cancer Hospital of Shantou University Medical College, Guangdong, China.
authors.forename: Yu-Su
authors.initials: YS
authors.lastname: Yang
authors.affiliation: Department of Head and Neck Surgery, the Cancer Hospital of Shantou University Medical College, Guangdong, China.
authors.forename: Wei-Zheng
authors.initials: WZ
authors.lastname: Chen
authors.affiliation: Department of Information, the Cancer Hospital of Shantou University Medical College, Guangdong, China.
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Zhang
authors.affiliation: The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Guangdong, China. Department of Biochemistry and Molecular Biology, Shantou University Medical College, Guangdong, China. lyxu@stu.edu.cn nmli@stu.edu.cn.
authors.forename: En-Min
authors.initials: EM
authors.lastname: Li
authors.affiliation: The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Guangdong, China. Institute of Oncologic Pathology, Shantou University Medical College, Guangdong, China. lyxu@stu.edu.cn nmli@stu.edu.cn.
authors.forename: Li-Yan
authors.initials: LY
authors.lastname: Xu
mesh_terms: D000914:Antibodies, Viral / Q000097:blood* / Q000276:immunology; D000956:Antigens, Viral / Q000097:blood / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D014408:Biomarkers, Tumor / Q000097:blood* / Q000276:immunology; D036022:Capsid Proteins / Q000097:blood* / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D001323:Autoantibodies; D014408:Biomarkers, Tumor; D036022:Capsid Proteins; C041788:Epstein-Barr viral capsid antigen; D007070:Immunoglobulin A