| Nasopharyngeal carcinoma (NPC; WHO type II/III) is a highly prevalent cancer (4-35/100.000) in Southern China, most of SE-Asia and Indonesia and Northern Africa and is 100% associated with EBV. Patients usually come to the clinic at advanced stage of disease (III-IV) because early-stage symptoms are non-specific and frequently ignored. Down-staging of NPC at presentation is important to improve treatment outcome and reduce morbidity and mortality. Our project aims to identify patients at early stage, by screening risk populations, by analysing risk factors and involving local and regional hospitals in a NPC network. Using a mixture of EBV-specific peptide antigens we created a one-step IgA-ELISA assay that allows identification of NPC patients with high sensitivity and specificity 1 . A confirmation ELISA based on a different set of EBV antigens was recently developed also 2 . We analysed sera from 350 healthy Indonesian persons, 245 NPC patients at primary diagnosis and several non-NPC patients as controls and achieved > 95% sensitivity and specificity values for the double ELISA system. We demonstrated that dried whole blood on filter paper is feasible as a sample for remote collection in field hospitals. Good correlation was found with freshly collected serum/plasma 3 . High risk patients are defined as having suspicious persistent complaints in the head and neck and are being collected from ENT, ophthalmology and neurology clinics in the Yogyakarta region. We have developed a detailed questionnaire, in collaboration with dr. M.Corbex at WHO-IARC 4 , for collecting information on possible life-style and environmental risk factors among NPC patients, matched controls and family members. In addition, blood samples are being collected for (epi)genetic analysis at IARC. |
