Evaluation of Anti-BNLF2b Antibody and Epstein–Barr Virus Biomarkers for the Diagnosis of Nasopharyngeal Carcinoma: A Retrospective Study

ObjectiveTo validate the diagnostic performance of anti-BNLF2b antibody for detecting nasopharyngeal carcinoma (NPC) compared with healthy controls (HC).MethodsWe conducted a retrospective study including 220 patients with NPC, 61 with tongue cancer (TC), and 88 HC patients. We collected demographic and clinical data, including anti-BNLF2b antibody, EBV DNA, VCA-IgA, EBNA1-IgA, and Rta-IgG. Propensity score matching (PSM) was used to balance baseline characteristics between NPC and comparison groups. Associations between biomarkers and NPC diagnosis were examined using logistic regression. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis.ResultsAfter PSM, 88 patients with NPC were matched to 88 HC with balanced baseline characteristics. Anti-BNLF2b antibody levels were significantly higher in NPC and remained independently associated with NPC diagnosis. For NPC versus HC, anti-BNLF2b antibody showed excellent discrimination (AUC = 0.990; sensitivity 98.9%; specificity 92.0% at a cut-off of 0.210), exceeding the performance of the EBV dual antibody risk probability (AUC: 0.872; P < 0.001). In addition, patients with NPC had higher anti-BNLF2b antibody levels and other EBV-related markers than those with TC.ConclusionIn this retrospective study, anti-BNLF2b antibody demonstrated excellent discrimination for NPC. It may serve as a complementary serologic marker, pending external validation and prospective assessment of clinically optimized cutoffs.