鼻咽癌（NPC）是印度尼西亚最常见的头颈部癌症，在肿瘤细胞中100％存在EB病毒（EBV）感染。鼻咽癌在荷兰很少见。 EBV在NPC发病机制中的参与可由对不同EBV蛋白早期发生异常IgA抗体应答的多样性（免疫印迹）所反映。提议在流行地区进行增高EBV-IgA水平的筛查以评估NPC风险，但在非流行地区研究薄弱。本研究分析了印度尼西亚（n = 50）和荷兰（n = 50）NPC患者对EBV蛋白VCA P18、EBNA 1和Zebra（Zta）（N-terminus、P 125、P 130、全长重组Zebra）的免疫印迹整体多样性以及IgA应答的流行率和归一化水平。结果证实了IgA-VCA P18和IgA-EBNA 1水平在两个NPC人群中均升高，但IgA-Zta更具变异性。印度尼西亚NPC患者中IgA-Zta应答更为显著，总体上反映了更频繁的EBV复活。 IgA-VCA P18和IgA-EBNA是独立的肿瘤标志物，且两者均对NPC风险评估至关重要。总体而言，这些结果证实了在流行和非流行人群中结合进行IgA-VCA P18/-EBNA 1测试对于评估NPC风险的诊断效益。版权所有© 2023 The Author(s)。由Wolters Kluwer Health, Inc.出版。

Nasopharyngeal carcinoma (NPC) is the most prevalent head and neck cancer in Indonesia, with 100% Epstein-Barr virus (EBV) infection in tumor cells. NPC is rare in the Netherlands. The involvement of EBV in NPC pathogenesis is reflected by early onset aberrant IgA antibody responses to various EBV proteins. Screening for elevated EBV-IgA levels is proposed for NPC risk assessment in endemic countries but is poorly studied in nonendemic regions. This study analyzed the overall diversity (immunoblot) as well as the prevalence and normalized levels of IgA responses to immunodominant peptide epitopes of EBV proteins VCA P18, EBNA 1, and Zebra (Zta) (N-terminus, P 125, P 130, full-length recombinant Zebra) in Indonesian (n=50) and Dutch (n=50) patients with NPC. The results confirmed that elevated levels of IgA-VCA P18 and IgA-EBNA 1 were found in both NPC populations, but that IgA-Zta was more variable. IgA-Zta responses were more pronounced in Indonesian NPC cases, reflecting more frequent EBV reactivation overall. IgA-VCA P18 and IgA-EBNA are independent tumor markers and are both necessary for NPC risk assessment. Overall, these results confirmed the diagnostic benefit of combined IgA-VCA P18/-EBNA 1 testing for NPC risk assessment in endemic and nonendemic populations.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.