5 Sept 2023 • Nasopharyngeal Carcinoma is ubiquitously associated with EBV infection and population screening of asymptomatic persons with Epstein–Barr virus (EBV) DNA or antibodies can improve the diagnosis of nasopharyngeal carcinoma and survival among those affected.

However, the positive predictive value of current screening strategies has been unsatisfactory even in areas where EBV is endemic. Most of the high-risk participants who had been identified through primary serologic screening were subjected to unnecessary and time - consuming clinical examinations and follow-ups. The low positive predictive value hampered the cost-effectiveness and capacity of nasopharyngeal carcinoma screening but also resulted in long-term anxiety and low adherence amongst the participants. The results achieved so far have been limited by low sensitivity, complex operations, or high cost.

In an effort to curtail these issues, the genome of EBV encoding more than 80 proteins was studied along with its antibodies. In due course, anti–BNLF2b total antibody (P85-Ab) was identified and validated as a novel serologic biomarker for nasopharyngeal carcinoma screening.

• A large-scale, prospective screening program was conducted to compare P85-Ab with the
  standard screening method (two - antibody screening).
• The results showed that P85-Ab had higher sensitivity (97.9% vs. 72.3%), higher specificity (98.3% vs. 97.0%), and a higher positive predictive value (10.0% vs. 4.3%) than the standard screening method.

The combination of P85-Ab with other biomarkers could further enhance the positive predictive value of nasopharyngeal carcinoma screening and subsequently improve its cost-effectiveness, capacity, and acceptance, eventually decreasing nasopharyngeal carcinoma–associated mortality.

Source: NEJM | Read full story