Epstein-Barr virus (EBV)-based serologic antibody testing has been found to be a feasible alternative for nasopharyngeal carcinoma (NPC) screening in endemic areas. The purpose of this study was to evaluate the performance of ELISA based on VCA IgA antibody, EA-IgA and Rta-IgG antibody specific to EBV in the diagnosis of NPC. A total of 2155 untreated NPC patients and 6957 healthy volunteers without nasopharyngeal disorder were recruited, and all subjects received EBV VCA-IgA, EA-IgA and Rta-IgG antibody tests simultaneously. The diagnostic efficiency of three testing alone or in combination for the diagnosis of NPC was evaluated. The prevalence of IgA antibody against EBV-VCA, IgA antibody against EBV-EA and IgG antibody against EBV-Rta was 89.9%, 46.6% and 63.2%. The sensitivity, specificity, positive predictive value, negative predictive value and Youden index were 89.88%, 89.65%, 73.18%, 96.63% and 0.79 for the EBV VCA-IgA antibody test, 46.59%, 96.89%, 82.5%, 85.42% and 0.43 for the EA-IgA antibody test, and 63.25%, 94.87%, 79.48%, 89.29% and 0.58 for the Rta-IgG antibody test in the diagnosis of NPC, and ROC curve analysis revealed the greatest diagnostic efficiency for EBV VCA-IgA antibody test and the lowest efficiency for EBV EA-IgA antibody test in the diagnosis of NPC. In addition, the simultaneous triple positivity of VCA-IgA, EA-IgA and Rta-IgG antibodies specific to EBV indicated the highest risk of NPC, and the simultaneous triple negativity of the three types of anti-EBV antibodies suggested the lowest risk of NPC. Our data demonstrate that EBV VCA-IgA antibody test shows a higher diagnostic efficiency than EA-IgA and Rta-IgG antibody tests for the screening of NPC, and triple positivity of is a better biomarker for the diagnosis of NPC.

基于爱泼斯坦-巴尔病毒（EBV）的血清抗体检测已被发现是在流行地区筛查鼻咽癌（NPC）的可行替代方法。这项研究的目的是评估针对EBV的VCA IgA抗体，EA-IgA和Rta-IgG抗体的ELISA在NPC诊断中的性能。总共招募了2155名未经治疗的NPC患者和6957名没有鼻咽疾病的健康志愿者，所有受试者同时接受了EBV VCA-IgA，EA-IgA和Rta-IgG抗体测试。评估了三种单独检测或组合检测对NPC的诊断效率。抗EBV-VCA的IgA抗体，抗EBV-EA的IgA抗体和抗EBV-Rta的IgG抗体的发生率分别为89.9％，46.6％和63.2％。敏感性，特异性，阳性预测值，EBV VCA-IgA抗体检测的阴性预测值和Youden指数分别为89.88％，89.65％，73.18％，96.63％和0.79，EA-IgA抗体检测的46.59％，96.89％，82.5％，85.42％和0.43， Rta-IgG抗体检测对NPC的诊断分别为63.25％，94.87％，79.48％，89.29％和0.58，ROC曲线分析显示EBV VCA-IgA抗体检测的诊断效率最高，而EBV EA的最低效率-IgA抗体检测对NPC的诊断。另外，对EBV特异性的VCA-IgA，EA-IgA和Rta-IgG抗体同时具有三重阳性，表明NPC风险最高，而三种抗EBV抗体同时具有三重阴性，则表明NPC风险最低。 。