Accuracy Evaluation and Comparison of 14 Diagnostic Markers for Nasopharyngeal Carcinoma: A Meta-Analysis

Abstract

The aim of the present study was to collect published studies and compare the diagnostic accuracy of different markers for nasopharyngeal carcinoma (NPC). We systematically searched PubMed/MEDLINE, EMBASE, Cochrane Library, CNKI, and Wanfang for relevant studies until April 29, 2020. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate the methodological quality of the studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) values of the diagnostic markers were combined by a bivariate mixed effect model to compare their diagnostic accuracy. We explored heterogeneity through meta-regression. In total, 244 records from 101 articles were included, with 49,432 total study subjects (13,109 cases and 36,323 controls). EA-IgG, Zta-IgG, and Epstein-Barr virus (EBV) DNA load in non-invasive nasopharyngeal brushings (EBV-DNA brushings) have both high sensitivity and specificity, EBNA1-IgG and VCA-IgG have only high sensitivity, and EBNA1-IgA, VCA-IgA, Rta-IgG, Zta-IgA, HSP70, and serum sialic acid (SA) have only high specificity. The bivariate mixed effect model of EA-IgA had a significant threshold effect. Meta-regression analysis showed that ethnicity affected EBNA1-IgA, EBNA1-IgG, VCA-IgA, and EBV DNA load in plasma, test methods affected EBNA1-IgG, publication year affected VCA-IgA, and sample size affected Rta-IgG. There was significant publication bias for VCA-IgA and Rta-IgG (P < 0.05). EA-IgG, Zta-IgG, and EBV-DNA brushings are good diagnostic markers for NPC. The diagnostic accuracy was influenced by publication year, sample size, test methods, and ethnicity.

Association between HLA alleles and Epstein–Barr virus Zta‐IgA serological status in healthy males from southern China

“… 18 Antibodies against lytic EBV proteins including capsid antigen (VCA), BZLF1 transcription activator protein (Zta) and early antigen (EA) have shown great potential to stratify NPC cases and controls (area under the curve = 0.90–0.93). 19 , 20 Individuals with elevated levels of immunoglobulin (Ig)A antibodies against lytic EBV proteins have a 20‐ to 30‐fold higher risk of NPC. 21 Longitudinal cohort studies have revealed that the elevated IgA level precedes the occurrence of NPC by 1–15 years.…”

Performance of Plasma HSP90α, Serum EBV VCA IgA Antibody and Plasma EBV DNA for the Diagnosis and Prognosis Prediction of Nasopharyngeal Carcinoma

“…30 Nevertheless, serum EBV Zta antibody is not popular for the identification of NPC in clinical practices. 31 Heat shock protein (HSP), also termed stress protein, is a class of proteins that are highly expressed in cells in response to physicochemical stimuli. 32 Based on the molecular weight, HSPs are classified into HSP110, HSP90, HSP70, HSP60 and small HSPs (sHSPs).…”

Epstein-Barr-Virus-assoziierte Erkrankungen bei Kindern und Jugendlichen

“…Eine EBV-Assoziation besteht darüber hinaus mit verschiedenen epithelialen Neoplasien, darunter fast allen Nasopharynxkarzinomen (NPC) und 10 % der Magenkarzinome [1]. Beim Monitoring des NPC haben sich EBV-spezifische Antikörper und Viruslast im Blut als hilfreich erwiesen [47].…”