Nasopharyngeal Cancer

Serologic Markers of Epstein–Barr Virus Infection and Nasopharyngeal Carcinoma in Taiwanese Men

Yin-Chu Chien, M.Sc., Jen-Yang Chen, Ph.D., Mei-Ying Liu, Ph.D., Hwai-I Yang, M.Sc., Mow-Ming Hsu, M.D., Chien-Jen Chen, Sc.D., and Czau-Siung Yang, M.D.



It is probable but unproven that Epstein–Barr virus (EBV) has a role in nasopharyngeal carcinoma. We determined whether antibodies against EBV are present before the development of nasopharyngeal carcinoma.


A total of 9699 men were enrolled between 1984 and 1986. Blood samples were examined for IgA antibodies against EBV capsid antigen and neutralizing antibodies against EBV-specific DNase. During 131,981 person-years of follow-up, 22 pathologically confirmed new cases of nasopharyngeal carcinoma that were diagnosed more than one year after recruitment were ascertained through linkage with the National Cancer Registry of Taiwan.


The cumulative risk of nasopharyngeal carcinoma per 100,000 person-years was 11.2 for subjects who tested positive for neither serologic marker, 45.0 for those who had one marker, and 371.0 for those who had both markers. After adjustment for age and the presence or absence of a family history of nasopharyngeal carcinoma, the relative risk of nasopharyngeal carcinoma was 32.8 for subjects with both markers (95 percent confidence interval, 7.3 to 147.2; P<0.001) and 4.0 for subjects with one marker (95 percent confidence interval, 1.6 to 10.2; P=0.003), as compared with subjects with neither marker.

The longer the duration of follow-up, the greater the difference in the cumulative incidence of nasopharyngeal carcinoma between seropositive and seronegative subjects.


IgA antibodies against EBV capsid antigen and neutralizing antibodies against EBV DNase are predictive of nasopharyngeal carcinoma.


Information From the Graduate Institute of Epidemiology, College of Public Health (Y.-C.C., H.Y., C.-J.C.), the Graduate Institute of Microbiology (J.-Y.C., C.-S.Y.), and the Department of Otolaryngology (M.-M.H.), College of Medicine, National Taiwan University, Taipei; and the Department of General Education, National Taipei College of Nursing, Taipei (M.-Y.L.) — all in Taiwan. Address reprint requests to Dr. Chien-Jen Chen at the Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, 1 Jen-Ai Rd., Sec. 1, Taipei 100, Taiwan, or at

New England J of Medicine Volume 345:1877-1882 December 27, 2001 Number 26

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