In a multicenter prospective cohort study of 3,777 participants with suspected nasopharyngeal carcinoma (NPC), anti–Epstein-Barr virus (EBV) BNLF2b total antibody (P85-Ab) demonstrated superior diagnostic performance compared to EBV viral capsid antigen (VCA)-immunoglobulin A, EBV early antigen-IgA, and EBV nuclear antigen 1-IgA.
P85-Ab showed high sensitivity and specificity across outpatient populations, particularly among asymptomatic individuals and those with NPC-nonspecific symptoms.
For patients with NPC-specific symptoms, a triplet-antibody strategy combining P85-Ab, VCA-IgA, and EBNA1-IgA further improved sensitivity, supporting distinct diagnostic approaches based on clinical presentation.
This multicenter, observational cohort study with prospective sample collection was conducted at 5 medical centers across 4 provinces in China. Participants were consecutively recruited from the ENT or oncology outpatient clinics of the following institutions: Sun Yat-sen University Cancer Centre (SYSUCC), Zhongshan City People’s Hospital (ZSCPH), Tongji Hospital affiliated with Tongji Medical College of Huazhong University of Science and Technology (TJH-HUST), Wuzhou Red Cross Hospital (WZRCH), and Fujian Cancer Hospital (FJCH).
Key inclusion criteria included participants with symptoms or signs suggestive of possible NPC, non-NPC head and neck diseases, EBV-associated diseases, and positive results from commercially available EBV-based tests without signs or symptoms in medical examination centers or screening initiatives and subsequently seeking further differential diagnosis of NPC. Key exclusion criteria included previous radiotherapy or systemic chemotherapy (detailed in eMethods 1 in Supplement 2).
