A serological mass survey was carried out in Wuzhou City in 1980, 1,136 IgA/VCA-positive persons being followed up for 4 years. Altogether 35 NPC cases were detected, of which 15 (43%) were in stage I and 17 (48.5%) in stage II, early cases (I + II) thus amounting to 91.5%. The detection rate of early cases was 2.9 times higher than in our outpatient clinic. IgA/VCA antibody could be detected 16-41 months prior to clinical diagnosis of NPC. We conclude that, if IgA/VCA-positive individuals are examined routinely once a year, NPC can be detected in the early stages of evolution. The annual detection rate of NPC in IgA/VCA antibody-positive individuals was 31.7 times higher than that of the annual incidence of NPC in the general population in the same age group, while during the 4-year follow-up period the incidence was 7.5 times higher than in the general population for the same age group. These results further indicate that EB virus plays an important role in the development of NPC, and that serological screening and follow-up studies are valuable for the early detection of NPC.

An immunoautoradiographic method was used for the detection of EB virus IgA/EA antibody in sera from NPC patients and other control groups. Ninety-six percent of NPC patients had IgA/EA antibody with a high titer of GMT. The positive rates of IgA/EA antibody in patients with malignant tumours other than NPC and in normal individuals were only 4% and 0%, respectively. Eleven patients histologically diagnosed as having a chronic inflammation and who showed positive for IgA/EA antibody by immunoautoradiography were rebiopsied; six of them were discovered to have squamous cell carcinoma. Fourteen NPC patients had no IgA/EA antibody detected by immunofluorescence and immunoenzymatic testing, but 11 and six of them had IgA/VCA and IgA/EA antibodies detected by immunoautoradiography, respectively. These data indicate that the immunoautoradiographic method is more sensitive than either the immunofluorescence or immunoenzymatic test for the detection of IgA/EA antibody, and can be used for the detection of NPC in the early stages of development.