Can an Anti-EBV Antibody Assist in Screening for Nasopharyngeal Cancer?

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In a Chinese study reported in The New England Journal of Medicine, Li et al found evidence that the anti–Epstein-Barr virus (EBV) anti-BNLF2b total antibody, P85-Ab, may be a promising biomarker for nasopharyngeal cancer screening.

Study Details

In the study, a peptide library representing highly ranked B-cell epitopes of EBVcoding sequences was designed to identify novel serologic biomarkers for nasopharyngeal carcinoma. A retrospective case-control study was performed to identify the most promising marker, which was then compared with the standard two-antibody–based screening method consisting of EBV nuclear antigen 1 (EBNA1-IgA) and EBV-specific viral capsid antigen (VCA–IgA) in a prospective cohort.

Key Findings

In the case-control study, the most promising biomarker for nasopharyngeal carcinoma screening was P85-Ab, which exhibited a sensitivity of 94.4% (95% confidence interval [CI] = 86.4%–97.8%) and a specificity of 99.6% (95% CI = 97.8%–99.9%).

Among 24,852 individuals in the prospective cohort, 47 cases of nasopharyngeal carcinoma were identified, including 38 early-stage cases. Compared with the standard two-antibody method, P85-Ab exhibited higher sensitivity (97.9% [95% CI = 88.9%–99.6%) vs 72.3% [95% CI = 58.2%–83.1%], ratio = 1.4, 95% CI = 1.1–1.6), higher specificity (98.3% [95% CI = 98.2%–98.5%] vs 97.0% [95% CI = 96.7–97.2%], ratio = 1.01, 95% CI = 1.01–1.02), and higher positive predictive value (10.0% [95% CI = 7.6%–13.1%] vs 4.3% [95% CI = 3.1%–6.0%], ratio = 2.3, 95% CI = 1.8–2.8).

The combination of P85-Ab and the two-antibody method increased the positive predictive value to 44.6% (95% CI = 33.8%–55.9%) at a sensitivity of 70.2% (95% CI = 56.0%–81.4%).

The investigators concluded, “Our results suggest that P85-Ab is a promising novel biomarker for nasopharyngeal carcinoma screening, with higher sensitivity, specificity, and positive predictive value than the standard two-antibody method.”

Shengxiang Ge, PhD, and Ningshao Xia, of the State Key Laboratory of Vaccines for Infectious Diseases, Xiamen, and Mingfang Ji, MM, of the Cancer Research Institute of Zhongshan City, are the corresponding authors for The New England Journal of Medicine article. 

Disclosure: The study was funded by the National Key Research and Development Program of China and others. For full disclosures of the study authors, visit

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