A study by researchers at Oxford Population Health and Peking University has found that measuring just 2 or 4 antibodies for Epstein-Barr virus (EBV) may be able to improve early detection of nasopharyngeal carcinoma (NPC) in Chinese adults. The study is published in the International Journal of Epidemiology.
NPC is a type of head and neck cancer that affects the part of the throat that connects the back of the nose to the back of the mouth. While NPC is relatively rare worldwide, there are areas of the world where it is much more common. In some parts of Southern China, rates of NPC are more than 25 times higher than other parts of China. Diagnosing NPC early is crucial because the 5-year survival rate for people diagnosed early is more than 95%, compared with 50% for people diagnosed at more advanced stages.
Previous studies have shown that some indicators for EBV, the virus responsible for glandular fever, have been associated with an increased risk of NPC. This study aimed to assess the association of 16 EBV antigens (biological markers that indicate whether or not the virus is present in the body) with NPC and evaluate two marker combinations for predicting risk of NPC.
The study used data from participants in the China Kadoorie Biobank (CKB), a long-term collaborative study between Oxford Population Health and Peking University, which recruited over 500,000 healthy adults from 10 diverse areas in China during 2004 and 2008. Two of the areas included in the study have higher rates of NPC. This study used multiplex serology assay to quantify IgA and IgG antibodies against 16 EBV antigens in stored baseline plasma samples among 245 participants who had been diagnosed with NPC after joining the study and 745 people who did not have NPC.
Key findings:
- NPC was more common in men and older people, and more common in participants from regions where NPC rates are known to be higher;
- Participants with NPC were also more likely to be smokers, alcohol drinkers, have a lower BMI, and more likely to have a family history of cancer;
- EBV was associated with a higher risk of NPC. The markers for EBV associated with the highest risk of NPC were BGLF2, LF2, and BFRF1;
- Both of the four- and two-marker combinations evaluated showed strong predictive abilities for NPC (C-statistics of ~0.85), which persisted for at least five years before disease diagnosis in both NPC endemic and non-endemic areas.
Dr Ling Yang, Senior Epidemiologist at Oxford Population Health and lead author of the study, said ‘Our findings demonstrate that markers for EBV can be used to predict the risk of NPC in Chinese adults many years before diagnosis. The use of the two marker combinations found in this study could be used to identify high-risk individuals to improve early detection and outcomes.’