IgA RESPONSE TO EARLY ANTIGEN (IgA-EAext) OF EPSTEINBARR VIRUS (EBV) IN HEALTHY POPULATION AND NASOPHARYNGEAL CARCINOMA (NPC) PATIENTS : POTENCY AS A DIAGNOSIS AND SCREENING TOOL
ABSTRACT: Background: Nasopharyngeal carcinoma (NPC) is one of Epstein-Barr Virus (EBV) associated malignancies. More than 80% NPC are diagnosed at the late stage with consequences on the therapy failure. Therefore, the development of early detection method are very crucial. Objective: To examine the potency of IgA-EAext as a diagnostic and screening tool; to examine the potency of IgA-EAext as a single diagnostic and screening tool or used as a combination with IgA-[EBNA1+VCAp18] response. Methods: Cross sectional study in healthy population (n=120) and histopathologicaly confirmed NPC patients (n=120). IgA-EAext response was detected using ELISA method. The mean of IgA-EAext responses were tested using independent T-test. Kendall�¢ï¿½ï¿½s concordance test was used to examine the concordancy between IgA-EAext and IgA-[EBNA1+VCAp18] responses. Cutoff value, sensitivity, specificity were determined by using ROC analysis, also calculation of positive predictive value (ppv) and negative predictive value (npv). Results: Cutoff value of IgA-EAext was 0.274. 90.76% (108/119) of NPC patients had positive response, while 2.5% (3/120) of healthy individuals had negative result. Sensitivity, specificity, ppv and npv of IgAEAext response were 90.76%, 97.50%, 97.29% and 91.4%. The combination of IgA-EAext with IgA-[EBNA1+VCAp18] response had a sensitivity of 86.55%, specificity of 100%, ppv of 100%, and npv of 88.23%. Conclusion: IgA-EAext is a potential method for a single NPC diagnosis and screening tool, or as a combination with IgA-[EBNA1+VCAp18]. Combination of IgA-EAext and IgA-[EBNA1+VCAp18] can be used as a confirmatory test of the IgA-EAext as the initial test.
ABSTRACT: Background: Nasopharyngeal carcinoma (NPC) is one of Epstein-Barr Virus (EBV) associated malignancies. More than 80% NPC are diagnosed at the late stage with consequences on the therapy failure. Therefore, the development of early detection method are very crucial. Objective: To examine the potency of IgA-EAext as a diagnostic and screening tool; to examine the potency of IgA-EAext as a single diagnostic and screening tool or used as a combination with IgA-[EBNA1+VCAp18] response. Methods: Cross sectional study in healthy population (n=120) and histopathologicaly confirmed NPC patients (n=120). IgA-EAext response was detected using ELISA method. The mean of IgA-EAext responses were tested using independent T-test. Kendall�¢ï¿½ï¿½s concordance test was used to examine the concordancy between IgA-EAext and IgA-[EBNA1+VCAp18] responses. Cutoff value, sensitivity, specificity were determined by using ROC analysis, also calculation of positive predictive value (ppv) and negative predictive value (npv). Results: Cutoff value of IgA-EAext was 0.274. 90.76% (108/119) of NPC patients had positive response, while 2.5% (3/120) of healthy individuals had negative result. Sensitivity, specificity, ppv and npv of IgAEAext response were 90.76%, 97.50%, 97.29% and 91.4%. The combination of IgA-EAext with IgA-[EBNA1+VCAp18] response had a sensitivity of 86.55%, specificity of 100%, ppv of 100%, and npv of 88.23%. Conclusion: IgA-EAext is a potential method for a single NPC diagnosis and screening tool, or as a combination with IgA-[EBNA1+VCAp18]. Combination of IgA-EAext and IgA-[EBNA1+VCAp18] can be used as a confirmatory test of the IgA-EAext as the initial test.
