Potential of non-specific blood biomarkers combined with EBV-specific antibodies for triaging in nasopharyngeal carcinoma screening

Although previous studies have indicated a link between Epstein-Barr virus (EBV) antibody positivity and increased risk of nasopharyngeal carcinoma (NPC), there is a lack of detailed analysis on the association between EBV antibody profile and various health examination indicators. In a retrospective cohort study involving 4,600 healthy subjects recruited from the physical examination center at Zhongshan City People’s Hospital (single-center), we collected demographic and EBV serological data. Levels of serum EBV antibodies were assessed through an enzyme-linked immunosorbent assay (ELISA). After controlling for age and sex, binary and ordinal logistic regressions were employed to compare the levels of health examination indicators between groups with different EBV antibody results. The levels of EBNA1-IgA, VCA-IgA, Zta-IgA, and Rta-IgG were significantly higher in the Positive group (positivity in any of the four EBV antibodies) compared to the Negative group (negativity of all four EBV antibodies). Additionally, the Positive group exhibited significant differences in several biochemical indicators compared to the Negative group. Binary and ordinal regressions constantly suggested that higher levels of globulin (GLO; OR = 1.03, 95% CI = 1.01–1.06) and carcinoembryonic antigen (CEA; OR = 1.07, 95% CI = 1.01–1.15), along with lower lymphocyte percentage (LYM%; OR = 0.99, 95% CI = 0.98–1.00) and low-density lipoprotein cholesterol (LDL-C; OR = 0.84, 95% CI = 0.77–0.92) were associated with higher EBV antibody seropositivity (p < 0.05). Integrating certain health examination indicators (such as GLO, CEA, and LYM%) with EBV antibody tests may serve as informative indicators, pending validation, to enhance screening accuracy for early NPC detection.