Anti–Epstein–Barr Virus BNLF2b for Mass Screening for Nasopharyngeal Cancer

This multicenter Chinese study evaluates anti-BNLF2b total antibody (P85-Ab) as a novel screening biomarker for nasopharyngeal carcinoma (NPC), comparing it with the standard two-antibody method (EBNA1-IgA and VCA-IgA). In a retrospective case-control study (126 NPC cases, 789 controls), P85-Ab showed 94.4% sensitivity and 99.6% specificity. A prospective screening program (N=24,852 adults) detected 47 NPC cases, with P85-Ab outperforming standard methods:

• Sensitivity: 97.9% vs. 72.3%

• Specificity: 98.3% vs. 97.0%

• Positive Predictive Value (PPV): 10.0% vs. 4.3% Combining P85-Ab with the two-antibody algorithm increased PPV to 44.6% while maintaining similar sensitivity (70.2%). The biomarker was specific even in EBV-associated conditions like lymphoma and infectious mononucleosis. Authors conclude P85-Ab enables more accurate NPC screening with fewer false positives and reduced burden from unnecessary follow-ups.

This multicenter Chinese study evaluates anti-BNLF2b total antibody (P85-Ab) as a novel screening biomarker for nasopharyngeal carcinoma (NPC), comparing it with the standard two-antibody method (EBNA1-IgA and VCA-IgA). In a retrospective case-control study (126 NPC cases, 789 controls), P85-Ab showed 94.4% sensitivity and 99.6% specificity. A prospective screening program (N=24,852 adults) detected 47 NPC cases, with P85-Ab outperforming standard methods:

• Sensitivity: 97.9% vs. 72.3%

• Specificity: 98.3% vs. 97.0%

• Positive Predictive Value (PPV): 10.0% vs. 4.3% Combining P85-Ab with the two-antibody algorithm increased PPV to 44.6% while maintaining similar sensitivity (70.2%). The biomarker was specific even in EBV-associated conditions like lymphoma and infectious mononucleosis. Authors conclude P85-Ab enables more accurate NPC screening with fewer false positives and reduced burden from unnecessary follow-ups.