PT  - JOURNAL ARTICLE
AU  - Coghill, Anna E.
AU  - Hsu, Wan-Lun
AU  - Pfeiffer, Ruth M.
AU  - Juwana, Hedy
AU  - Yu, Kelly J.
AU  - Lou, Pei-Jen
AU  - Wang, Cheng-Ping
AU  - Chen, Jen-Yang
AU  - Chen, Chien-Jen
AU  - Middeldorp, Jaap M.
AU  - Hildesheim, Allan
TI  - Epstein–Barr Virus Serology as a Potential Screening Marker for Nasopharyngeal Carcinoma among High-Risk Individuals from Multiplex Families in Taiwan
AID  - 10.1158/1055-9965.EPI-13-1262
DP  - 2014 Jul 01
TA  - Cancer Epidemiology Biomarkers & Prevention
PG  - 1213--1219
VI  - 23
IP  - 7
4099  - http://cebp.aacrjournals.org/content/23/7/1213.short
4100  - http://cebp.aacrjournals.org/content/23/7/1213.full
SO  - Cancer Epidemiol Biomarkers Prev2014 Jul 01; 23
AB  - Background: Nasopharyngeal carcinoma (NPC) is an Epstein–Barr virus (EBV)–associated cancer that is highly treatable when diagnosed early, with 5-year disease-free survival of approximately 90%. However, NPC is typically diagnosed at advanced stages, in which disease-free survival is <50%. There is, therefore, a need for clinical tools to assist in early NPC detection, particularly among high-risk individuals. Methods: We evaluated the ability of anti-EBV IgA antibodies to detect incident NPC among high-risk Taiwanese individuals. NPC cases (N = 21) and age- and sex-matched controls (N = 84) were selected. Serum collected before NPC diagnosis was tested for ELISA-based IgA antibodies against the following EBV peptides: EBNA1, VCAp18, EAp138, Ead_p47, and VCAp18 + EBNA1 peptide mixture. The sensitivity, specificity, and screening program parameters were calculated. Results: EBNA1 IgA had the best performance characteristics. At an optimized threshold value, EBNA1 IgA measured at baseline identified 80% of the high-risk individuals who developed NPC during follow-up (80% sensitivity). However, approximately 40% of high-risk individuals who did not develop NPC also tested positive (false positives). Application of EBNA1 IgA as a biomarker to detect incident NPC in a previously unscreened, high-risk population revealed that 164 individuals needed to be screened to detect 1 NPC and that 69 individuals tested positive per case detected. Conclusions: EBNA1 IgA proved to be a sensitive biomarker for identifying incident NPC, but future work is warranted to develop more specific screening tools to decrease the number of false positives. Impact: Results from this study could inform decisions about screening biomarkers and referral thresholds for future NPC early-detection program evaluations. Cancer Epidemiol Biomarkers Prev; 23(7); 1213–9. ©2014 AACR.