Subtype distribution and long-term titer fluctuation patterns of serum anti-Epstein–Barr virus antibodies in a non-nasopharyngeal carcinoma population from an endemic area in South China: a cohort study

Cancer Communications

Rui Gao¹  Ming-Huang Hong¹  Sui-Hong Chen¹  Shang-Hang Xie²  Qi-Hong Huang³  Jie Guo³  Meng-Jie Yang⁴  Qing Liu⁵  Yan-Fang Ye⁵  Su-Mei Cao⁵  Jin-Lin Du⁵ 

[1] Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China;School of Public Health, Guangdong Medical University, Dongguan, P. R. China;School of Public Health, Sun Yat-sen University, Guangzhou, P. R. China;Sihui Cancer Institute, Sihui, P. R. China;State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China

关键词: Epstein–Barr virus;    Nasopharyngeal carcinoma;    Cohort study;    Mass screening;    Fluctuation;   

DOI  :  10.1186/s40880-016-0130-2

学科分类：肿瘤学

来源: Springer

【 摘 要 】

Serum immunoglobulin A antibodies against Epstein–Barr virus (EBV), viral capsid antigen (VCA-IgA) and early antigen (EA-IgA), are used to screen for nasopharyngeal carcinoma (NPC) in endemic areas. However, their routine use has been questioned because of a lack of specificity. This study aimed to determine the distributions of different subtypes of antibody and to illustrate how the natural variation patterns affect the specificity of screening in non-NPC participants. The distribution of baseline VCA-IgA was analyzed between sexes and across 10-year age groups in 18,286 non-NPC participants using Chi square tests. Fluctuations in the VCA-IgA level were assessed in 1056 non-NPC participants with at least two retests in the first 5-year period (1987–1992) after the initial screening using the Kaplan–Meier method. The titers of VCA-IgA increased with age (P < 0.001). Using a previous serological definition of high NPC risk, nasopharyngeal endoscopy and/or nasopharyngeal biopsy would be recommended in 55.5% of the non-NPC participants with an initial VCA-IgA-positive status and in 20.6% with an initial negative status during the 5-year follow-up. However, seroconversions were common; 85.2% of the participants with a VCA-IgA-positive status at baseline converted to negative, and all VCA-IgA-negative participants changed to positive at least once during the 5-year follow-up. The EA-IgA status had a high seroconversion probability (100%) from positive to negative; however, it had a low probability (19.6%) from negative to positive. Age- and sex-specific cutoff titer values for serum anti-EBV antibodies as well as their specific titer fluctuation patterns should be considered when defining high NPC risk criteria for follow-up diagnostics and monitoring.

【 授权许可】

CC BY