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<p>Nasopharyngeal carcinoma screening in southern China relies on Epstein–Barr virus serology, but its limited positive predictive value leads to excessive referrals. Here we evaluate a triage approach based on nasopharyngeal swab Epstein–Barr virus C promoter methylation quantification (E-CpMQ) among serology high-risk individuals in two population-based screening cohorts (<i>N</i> = 55,682). In the initial screening round (≤18 months) of a single-center cohort (<i>N</i> = 313), E-CpMQ identifies 91.7% of nasopharyngeal carcinoma cases (22/24) with 91.7% specificity (265/289), reducing referrals by 85.3%. Findings are replicated in an independent six-center cohort (N = 345), where E-CpMQ achieves 100% sensitivity (15/15) and 96.1% specificity (317/330), reducing referrals by 91.9%. Compared with nasopharyngeal swab Epstein–Barr virus DNA load triage, E-CpMQ shows equivalent sensitivity but higher specificity, lowering referrals needed to detect one case from 10–14 to approximately 2. Modeling further indicates improved specificity and positive predictive value when integrated into serology-based screening.</p>

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Nasopharyngeal carcinoma screening using Epstein–Barr virus Cp methylation triage in two population-based screening cohorts

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月22日

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  • Zhi-Cong Wu,
  • Xia Yu,
  • Guang-Cong Yi,
  • Sui-Ping Huang,
  • Dong-Ping Rao,
  • Jun Tao,
  • Shang-Hang Xie,
  • Tong Li,
  • Wen-Jie Chen,
  • Yan-Ping Fan,
  • Hua Chen,
  • Jun-Ping Ye,
  • Yong-Rui Ling,
  • Xiao-Juan Wen,
  • Lin Cao,
  • Ming-Fang Ji,
  • Ying Sun,
  • Allan Hildesheim,
  • Min-Zhong Tang,
  • Wei Ling,
  • Zhiwei Liu,
  • Su-Mei Cao

摘要

Nasopharyngeal carcinoma screening in southern China relies on Epstein–Barr virus serology, but its limited positive predictive value leads to excessive referrals. Here we evaluate a triage approach based on nasopharyngeal swab Epstein–Barr virus C promoter methylation quantification (E-CpMQ) among serology high-risk individuals in two population-based screening cohorts (N = 55,682). In the initial screening round (≤18 months) of a single-center cohort (N = 313), E-CpMQ identifies 91.7% of nasopharyngeal carcinoma cases (22/24) with 91.7% specificity (265/289), reducing referrals by 85.3%. Findings are replicated in an independent six-center cohort (N = 345), where E-CpMQ achieves 100% sensitivity (15/15) and 96.1% specificity (317/330), reducing referrals by 91.9%. Compared with nasopharyngeal swab Epstein–Barr virus DNA load triage, E-CpMQ shows equivalent sensitivity but higher specificity, lowering referrals needed to detect one case from 10–14 to approximately 2. Modeling further indicates improved specificity and positive predictive value when integrated into serology-based screening.