How Accurate is Screening for Nasopharyngeal Carcinoma?

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Clinical trial results for screening of nasopharyngeal cancer have shown a significant improvement in diagnosing accuracy for nasopharyngeal carcinoma. Trial results reported in the New England Journal of Medicine showed the novel biomarker P85-Ab, derived from Epstein-Barr virus (EBV) improved diagnostic performance in sensitivity, specificity, and positive predictive value compared to the standard two-antibody test. Results from screening for nasopharyngeal cancer comparing the novel biomarker P85-Ab to the standard two-antibody–based screening method.

  • sensitivity (97.9% vs 72.3%)
  • specificity (98.3% vs 97.0%)
  • positive predictive value (PPV; 10.0% vs 4.3%).

    • The standard two-antibody–based screening method was EBV nuclear antigen 1 [EBNA1]–IgA and EBV-specific viral capsid antigen [VCA]–IgA.

    Biomarker P85-Ab's high positive predictive value may improve the cost-effectiveness, capacity, and acceptance of nasopharyngeal carcinoma screening. Combining P85-Ab together with one or both of the standard antibodies would increase the positive predictive value further.

    Nasopharyngeal carcinoma

    Nasopharyngeal carcinoma is closely associated with the Epstein–Barr virus (EBV) which is classified as a group I carcinogen. The development of nasopharyngeal carcinoma is also influenced by genetic predisposition, and environmental factors including tobacco smoking, dietary components, and occupational exposure. Nasopharyngeal carcinoma (NPC) and gastric carcinoma accounted for 82% of EBV-attributed malignancies.

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