Sensitivity and specificity of Epstein-Barr virus IGA titer in the diagnosis of nasopharyngeal carcinoma: a three-year institutional review

Head Neck. 2004 Jul;26(7):598-602. doi: 10.1002/hed.20022.


Background: IgA antibody titers to the Epstein-Barr virus (EBV) viral capsid antigen (EBV IgA-VCA) and to the EBV early antigen (EBV IgA-EA) are used to screen for nasopharyngeal carcinoma (NPC). This study evaluates the sensitivity and specificity of EBV IgA-VCA and EBV IgA-EA titers in screening patients for NPC and in those diagnosed with NPC at our institution.

Methods: The NPC status was determined for all patients who had their EBV IgA-VCA and EBV-IgA EA titers measured over a 3-year period, and the sensitivity and specificity were calculated.

Results: Five thousand one hundred ninety-six samples were analyzed. NPC was diagnosed in 215 patients. The sensitivity and specificity of a raised EBV IgA-VCA titer (> or =1:5) for diagnosing NPC were 89% and 80%, respectively, with a raised EbV IgA-EA titer (> or =1:5) having a sensitivity and specificity of 63% and 97%, respectively.

Conclusions: Although the EBV IgA-VCA titer is sensitive for the diagnosis of NPC, it should not be used as the sole means of screening for NPC in a population in which NPC is endemic.

MeSH terms

  • Antibodies, Viral / blood
  • Antigens, Viral / immunology*
  • Biomarkers, Tumor / blood
  • Capsid / immunology*
  • Capsid Proteins / immunology*
  • Herpesvirus 4, Human
  • Humans
  • Immunoglobulin A / blood*
  • Nasopharyngeal Diseases / diagnosis*
  • Nasopharyngeal Diseases / virology
  • Sensitivity and Specificity


  • Antibodies, Viral
  • Antigens, Viral
  • Biomarkers, Tumor
  • Capsid Proteins
  • Epstein-Barr viral capsid antigen
  • Epstein-Barr virus early antigen
  • Immunoglobulin A