EB 病毒 (EBV) 是鼻咽癌 (NPC) 的主要原因，检测血液中不同 EBV 抗体可以改善鼻咽癌的早期发现。前瞻性研究有助于评估不同 EBV 抗体在预测 NPC 风险随时间变化方面的作用。中国嘉道理生物库前瞻性研究中进行了一项病例队列研究，对象为来自 10 个地区（包括两个 NPC 流行区）的 512 715 名成年人，其中包括 295 例鼻咽癌病例和 745 例亚队列参与者。使用多重血清学测定来量化储存的基线血浆样本中针对 16 种 EBV 抗原的 IgA 和 IgG 抗体。 Cox 回归用于估计 NPC 的调整后危险比 (HR) 和 C 统计量，以评估 EBV 标记物的辨别能力，包括两个先前识别的 EBV 标记物组合，用于预测 NPC。 16 种 EBV 中 15 种的血清阳性- 标志物与较高的​​ NPC 风险显着相关。针对相同的三个 EBV 标记物的 IgA 和 IgG 抗体都显示出最极端的 HR，即 BGLF2（IgA：124.2（95% CI：63.3-243.9）；IgG：8.6（5.5-13.5）；LF2：[67.8（30.0- 153.1)、10.9(7.2-16.4)])； BFRF1：26.1（10.1-67.5）、6.1（2.7-13.6）。使用两种标记物（即 LF2/BGLF2 IgG）和四种标记物（即 LF2/BGLF2 IgG 和 LF2/EA-D IgA）组合的 C 统计量分别为 0.85 和 0.84，且持续至少 5 年。在流行区和非流行区进行样本采集后数年。在中国成年人中，血浆 EBV 标记物在临床诊断前许多年就可以强烈预测 NPC 的发生。 LF2 和 BGLF2 IgG 可以识别 NPC 高危个体，以改善社区和临床环境中 NPC 的早期检测。© 作者 2024。由牛津大学出版社代表国际流行病学协会出版。

Epstein-Barr virus (EBV) is a major cause of nasopharyngeal carcinoma (NPC) and measurement of different EBV antibodies in blood may improve early detection of NPC. Prospective studies can help assess the roles of different EBV antibodies in predicting NPC risk over time.A case-cohort study within the prospective China Kadoorie Biobank of 512 715 adults from 10 (including two NPC endemic) areas included 295 incident NPC cases and 745 subcohort participants. A multiplex serology assay was used to quantify IgA and IgG antibodies against 16 EBV antigens in stored baseline plasma samples. Cox regression was used to estimate adjusted hazard ratios (HRs) for NPC and C-statistics to assess the discriminatory ability of EBV-markers, including two previously identified EBV-marker combinations, for predicting NPC.Sero-positivity for 15 out of 16 EBV-markers was significantly associated with higher NPC risk. Both IgA and IgG antibodies against the same three EBV-markers showed the most extreme HRs, i.e. BGLF2 (IgA: 124.2 (95% CI: 63.3-243.9); IgG: 8.6 (5.5-13.5); LF2: [67.8 (30.0-153.1), 10.9 (7.2-16.4)]); and BFRF1: 26.1 (10.1-67.5), 6.1 (2.7-13.6). Use of a two-marker (i.e. LF2/BGLF2 IgG) and a four-marker (i.e. LF2/BGLF2 IgG and LF2/EA-D IgA) combinations yielded C-statistics of 0.85 and 0.84, respectively, which persisted for at least 5 years after sample collection in both endemic and non-endemic areas.In Chinese adults, plasma EBV markers strongly predict NPC occurrence many years before clinical diagnosis. LF2 and BGLF2 IgG could identify NPC high-risk individuals to improve NPC early detection in community and clinical settings.© The Author(s) 2024. Published by Oxford University Press on behalf of the International Epidemiological Association.