{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:24:29Z","timestamp":1787667869472,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Antibodies to Epstein\u2010Barr virus (EBV) proteins can predict nasopharyngeal carcinoma (NPC) risk. We previously defined a prototype EBNA1 protein panel and multiplex immunoblot assay that distinguishes NPC risk several years pre\u2010diagnosis. Assay throughput and specificity are critical to effectively implement a population\u2010level screening program. Here, we developed a strip test assay\u2014EBNA1 SeroStrip\u2010HT\u2014with an objective to increase throughput and maximize specificity. EBNA1 full\u2010length (FL) and glycine\u2010alanine repeat deletion mutants (dGAr) were purified from insect and mammalian cells to screen serum IgA\/IgG from prospective cohorts in Singapore and Shanghai, China, with known time intervals to NPC diagnosis. Twenty pre\u2010diagnostic sera within 4 years to diagnosis were compared to 96 healthy controls using a nested case\u2010control study design. IgA to mammalian\u2010derived EBNA1 dGAr achieved 85.0% sensitivity and 94.8% specificity (AUC, 0.939) for NPC status. IgA to insect\u2010derived EBNA1 dGAr showed the same sensitivity (85.0%) and similar specificity (93.8%) (AUC, 0.941). IgA to insect\u2010derived EBNA1 FL had a higher 90% sensitivity, but lower 91.7% specificity (AUC, 0.940). Combining EBNA1 FL and dGAr results showed that subjects positive for both proteins had a 243.67 odds ratio for NPC incidence compared to double\u2010negative scores. This study demonstrated the efficacy of EBNA1 SeroStrip\u2010HT for NPC risk assessment and stratification in high\u2010 and intermediate\u2010risk populations, yielding high accuracy and a 12\u2010fold increased throughput over the prototype. The insect system was appropriate for large\u2010scale production of purified EBNA1. Larger, geographically diverse cohorts are warranted to confirm these results, especially in low\u2010incidence populations.<\/jats:p>","DOI":"10.1002\/jmv.71082","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T07:20:58Z","timestamp":1785136858000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Epstein\u2010Barr Virus Nuclear Antigen 1 (EBNA1) Serology Test Strip for Nasopharyngeal Carcinoma Risk Screening"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1550-1516","authenticated-orcid":false,"given":"Benjamin E.","family":"Warner","sequence":"first","affiliation":[{"name":"Cancer Virology Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"},{"name":"Cancer Epidemiology and Prevention Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"},{"name":"Department of Epidemiology, School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7610-1840","authenticated-orcid":false,"given":"Japan","family":"Patel","sequence":"additional","affiliation":[{"name":"Cancer Virology Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"},{"name":"Department of Biostatistics, School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0972-5959","authenticated-orcid":false,"given":"Rebecca","family":"Satterwhite","sequence":"additional","affiliation":[{"name":"Cancer Virology Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"},{"name":"Department of Epidemiology, School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA"},{"name":"Cancer Risk, Outcomes and Prevention Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8871-7054","authenticated-orcid":false,"given":"Renwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Cancer Risk, Outcomes and Prevention Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-3076","authenticated-orcid":false,"given":"Jennifer","family":"Adams\u2010Haduch","sequence":"additional","affiliation":[{"name":"Cancer Risk, Outcomes and Prevention Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5674-6341","authenticated-orcid":false,"given":"Woon\u2010Puay","family":"Koh","sequence":"additional","affiliation":[{"name":"Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4620-3108","authenticated-orcid":false,"given":"Jian\u2010Min","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA"},{"name":"Cancer Risk, Outcomes and Prevention Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9556-1745","authenticated-orcid":false,"given":"Kathy H. Y.","family":"Shair","sequence":"additional","affiliation":[{"name":"Cancer Virology Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"},{"name":"Cancer Risk, Outcomes and Prevention Program, UPMC Hillman Cancer Center University of Pittsburgh Pittsburgh Pennsylvania USA"},{"name":"Department of Microbiology and Molecular Genetics University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2022.2111711"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34154"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2196\/49968"},{"issue":"5","key":"e_1_2_9_5_1","first-page":"1189","article-title":"The Effect of Migration on the Risk of Nasopharyngeal Cancer Among Chinese","volume":"34","author":"Buell P.","year":"1974","journal-title":"Cancer Research"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.25287"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.07.702"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djad012"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws404"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz231"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.44.4.1459-1467.2006"},{"key":"e_1_2_9_12_1","unstructured":"L.FrappierEBNA1. 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