1. The serological diagnostic value of EBV-related IgA antibody panels for nasopharyngeal carcinoma: a diagnostic test accuracy meta-analysis.
- Author
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Liu H, Lei L, Song S, Geng X, Lin K, Li N, Chen W, Peng J, and Ren J
- Subjects
- Humans, Biomarkers, Tumor blood, Biomarkers, Tumor immunology, Early Detection of Cancer methods, Epstein-Barr Virus Nuclear Antigens immunology, Herpesvirus 4, Human immunology, Sensitivity and Specificity, Serologic Tests methods, Antibodies, Viral blood, Antibodies, Viral immunology, Epstein-Barr Virus Infections immunology, Epstein-Barr Virus Infections diagnosis, Epstein-Barr Virus Infections complications, Epstein-Barr Virus Infections blood, Immunoglobulin A blood, Immunoglobulin A immunology, Nasopharyngeal Carcinoma diagnosis, Nasopharyngeal Carcinoma immunology, Nasopharyngeal Carcinoma virology, Nasopharyngeal Carcinoma blood, Nasopharyngeal Neoplasms diagnosis, Nasopharyngeal Neoplasms immunology, Nasopharyngeal Neoplasms blood, Nasopharyngeal Neoplasms virology
- Abstract
Background: Nasopharyngeal carcinoma (NPC) is diagnosed relatively late and has a poor prognosis, requiring early detection to reduce the disease burden. This diagnostic test accuracy meta-analysis evaluated the serological diagnostic value of nine EBV-related IgA antibody panels (EBNA1-IgA, VCA-IgA, EA-IgA, Zta-IgA, EBNA1-IgA + VCA-IgA, VCA-IgA + EA-IgA, VCA-IgA + Rta-IgG, EBNA1-IgA + VCA-IgA + Zta-IgA and VCA-IgA + EA-IgA + Rta-IgG), aiming to identify suitable serological detection biomarkers for NPC screening., Methods: PubMed, Embase, China National Knowledge Infrastructure and Chinese BioMedical Literature Database were searched from January 1st, 2000 to September 30th, 2023, with keywords nasopharyngeal carcinoma, IgA, screening, early detection, early diagnosis, sensitivity and specificity. Articles on the diagnostic value of serum EBV-related IgA antibody panels for NPC were included. Study selection, data extraction, and quality assessment were performed independently by two researchers, and a third researcher was consulted in the case of disagreement. Bivariate models were used for statistical analysis. The quality of included studies was evaluated through Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2)., Results: A total of 70 articles were included, involving 11 863 NPC cases and 34 995 controls. Among the nine EBV-related IgA antibody panels, EBNA1-IgA + VCA-IgA [0.928 (0.898, 0.950)], VCA-IgA + Rta-IgG [0.925 (0.890, 0.949)], EBNA1-IgA + VCA-IgA + Zta-IgA [0.962 (0.909, 0.985)] and VCA-IgA + EA-IgA + Rta-IgG [0.945 (0.918, 0.964)] demonstrated higher pooled sensitivity (95%CI). In terms of diagnostic odds ratio (DOR) (95%CI), EBNA1-IgA + VCA-IgA [107.647 (61.173, 189.430)], VCA-IgA + Rta-IgG [105.988 (60.118, 186.857)] and EBNA1-IgA + VCA-IgA + Zta-IgA [344.450 (136.351, 870.153)] showed superior performance. Additionally, the SROC curves for EBNA1-IgA + VCA-IgA and VCA-IgA + Rta-IgG were more favorable. However, publication bias was detected for VCA-IgA (P = 0.005) and EBNA1-IgA + VCA-IgA (P = 0.042)., Conclusions: In general, parallel detection of serum EBNA1-IgA, VCA-IgA and Zta-IgA antibodies using ELISA demonstrates better pooled sensitivity and DOR among the studied panels. In the cases where fewer indicators are used, serum VCA-IgA and EBNA1-IgA/Rta-IgG antibody panel exhibits a comparable performance., Trial Registration: The International Prospective Register of Systematic Reviews registration number: CRD42023426984, registered on May 28, 2023., (© 2024. The Author(s).)
- Published
- 2024
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