Kinetics of EBV antibody-based NPC risk scores in Taiwan NPC multiplex families

Area of Science:

• Oncology
• Immunology
• Epidemiology

Background:

• Epstein-Barr virus (EBV)-antibody testing shows promise for nasopharyngeal carcinoma (NPC) screening.
• The long-term stability of EBV-antibody-based NPC risk prediction models remains unclear.

Purpose of the Study:

• To investigate the long-term stability and performance of two EBV-antibody NPC risk scores.
• To evaluate the impact of repeated testing on the specificity of NPC screening.

Main Methods:

• Assessed the stability of 2-marker ELISA and 13-marker multiplex serology scores over a 20-year follow-up in 545 participants.
• Utilized intra-class correlation coefficient (ICC) and linear mixed models to evaluate score stability.
• Employed Fleiss's kappa statistic to estimate the clustering of positive tests.

Main Results:

• The 2-marker score exhibited high long-term stability, while the 13-marker score was more variable (p < .05).
• Repeated testing enhanced specificity for the 2-marker score from ~90% to ~96% and for the 13-marker score from ~73% to ~92%.
• No score reversion was observed in individuals who developed NPC.

Conclusions:

• The 2-marker EBV-antibody score demonstrates robust long-term stability for NPC screening.
• Repeated testing can significantly improve the specificity of NPC screening, particularly in high-risk families.
• Further research is needed to assess sensitivity, optimal screening intervals, and generalizability to broader populations.