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Background: γ-Glutamylcyclotransferase (GGCT), an enzyme crucial in glutathione metabolism, has emerged as a participant in tumorigenesis. The present study is designed to elucidate the biological role and molecular mechanisms underlying GGCT in glioma. Methods: Gene Expression Profiling Interactive Analysis (GEPIA), Chinese Glioma Genome Atlas (CGGA), and PrognoScan online databases were utilized to examine the expressions and clinical prognosis of GGCT and REST in glioma. Cell Counting Kit-8 (CCK-8), Transwell, Wound healing, and Flow cytometric assays, and RNA-sequencing analysis were employed to uncover the molecular role of GGCT and REST. Prediction of Differentially expressed microRNA (DE-miRNAs) and miRNAs targeting GGCT 3′ Untranslated Region (UTR) was performed using miRanda online datasets. Finally, Real time-quantitative Polymerase Chain Reaction (RT-qPCR), western blot and dual luciferase reporter gene activity analysis were employed to confirm a positive feedback loop involving GGCT/REST/miR-34a-5p in glioma cells. Results: High expression of GGCT was correlated with poor prognosis in glioma. GGCT silencing demonstrated inhibitory effects on the proliferation, migration, and induction of apoptosis in T98G and U251 cells. Mechanistically, GGCT downregulated REST expression and modulated cancer-associated pathways in glioma cells. High expression of REST was associated with poor prognosis in glioma. In vitro and in vivo experiments showed that REST overexpression restored the repression of proliferation, invasion, migration, and xenograft tumor formation induced by GGCT knockdown. Furthermore, the study uncovered that REST inhibited miR-34a-5p mRNA expression, and miR-34a-5p suppressed GGCT expression by targeting its 3′UTR, forming a positive regulatory loop in glioma. Notably, the inhibitor of miR-34a-5p restored the role of REST silencing in decreasing GGCT expression in glioma cells. Conclusions: GGCT/REST/miR-34a-5p axis holds promising potential as a therapeutic target, offering a potential breakthrough in the treatment of glioma.

In this paper, the self-attention layer of a graph convolutional neural network is first constructed to output the important information in the network structure. The migration learning network model is established, and the sample data are preprocessed and trained sequentially. The final processing results are used as the initial data for abnormal power consumption detection. Introduce Bayes’ theorem to optimize the hyperparameters of the model. The optimized model is applied in the abnormal power consumption detection system to identify abnormal power consumption events and provide specific processing solutions. Through the detection of the system, it was found that the voltage of the test user dropped from a 100V cliff to about 20V in late November, which was determined by the system to be a power consumption abnormality, and, therefore, an operation and maintenance order was issued. The site survey revealed that the data was in line with the system detection. Calculating the power consumption information of another user, the phase voltage of this user stays around 85-100V, far below 150V, so the undercounting of power is verified for the user, and the amount of power that should be recovered is 201.22kW.

BackgroundAssociations between trace elements and nasopharyngeal carcinoma (NPC) have been speculated but not thoroughly examined.MethodsThis study registered a total of 225 newly diagnosed patients with NPC and 225 healthy controls matched by sex and age from three municipal hospitals in Guangdong Province, southern China between 2011 and 2015. Information was collected by questionnaire on the demographic characteristics and other possibly confounding lifestyle factors. Eight trace elements and the level of Epstein–Barr virus (EBV) antibody were measured in casual (spot) serum specimens by inductively coupled plasma–mass spectrometry (ICP-MS) and enzyme-linked immunosorbent assay (ELISA), respectively. Restricted cubic splines and conditional logistic regression were applied to assess the relationship between trace elements and NPC risk through single-and multiple-elements models.ResultsSerum levels of chromium (Cr), cobalt (Co), nickel (Ni), arsenic (As), strontium (Sr) and molybdenum (Mo) were not associated with NPC risk. Manganese (Mn) and cadmium (Cd) were positively associated with NPC risk in both single-and multiple-element models, with ORs of the highest tertile compared with the reference categories 3.90 (95% CI, 1.27 to 7.34) for Mn and 2.30 (95% CI, 1.26 to 3.38) for Cd. Restricted cubic splines showed that there was a linear increasing trend between Mn and NPC risk, while for Cd there was a J-type correlation.ConclusionSerum levels of Cd and Mn was positively related with NPC risk. Prospective researches on the associations of the two trace elements with NPC ought to be taken into account within the future.

Polygenic Risk Scores (PRS) show promise for facilitating cancer risk stratification. Here, the authors performed a large genome-wide association study and develop a PRS for nasopharyngeal carcinoma, which could improve risk stratification and personalized screening.

Abstract Glioblastoma (GBM) is the most common and aggressive malignant primary brain tumor. E3 ligases play important functions in glioma pathogenesis. CRISPR system offers a powerful platform for genome manipulation, while the screen of E3 ligases in GBM still remains to be explored. Here, we first constructed an E3 ligase small guide RNA (sgRNAs) library for glioma cells growth screening. After four passages, 299 significantly enriched or lost genes (SELGs) were compared with the initial state. Then the clinical significance of SELGs were validated and analyzed with TCGA glioblastoma and CGGA datasets. As RNF185 showed lost signal, decreased expression and favorable prognostic significance, we chose RNF185 for functional analysis. In vitro overexpressed cellular phenotype showed that RNF185 was a tumor suppressor in two glioma cell lines. Finally, the molecular mechanism of decreased RNF185 expression was investigated and increased miR-587 expression and DNA hypermethylation was evaluated. This study would provide a link between the molecular basis and glioblastoma pathogenesis, and a novel perspective for glioblastoma treatment.

Abstract Objective Plasma Epstein-Barr virus (EBV) DNA is considered a biomarker for nasopharyngeal carcinoma (NPC). However, its long-term role in NPC development is unclear. Materials and methods A total of 1363 participants seropositive for EBV VCA-IgA and EBNA1-IgA in a community-based NPC screening program in southern China were tested for plasma EBV DNA levels by real-time qPCR between 2008 and 2015. New NPC cases were confirmed by active follow-up approach and linkage to local cancer registry through the end of 2016. Cox proportional hazards regression analysis was performed to calculate the hazard ratios (HRs) for NPC risk with plasma EBV DNA. Results Thirty patients were newly diagnosed during a median 7.5 years follow-up. NPC incidence increased with the plasma EBV DNA load ranging from 281.46 to 10,074.47 per 100,000 person-years in participants with undetectable and ≥ 1000 copies/ml levels; the corresponding cumulative incidence rates were 1.73 and 50%. Furthermore, plasma EBV DNA loads conferred an independent risk for NPC development after adjustment for other risk factors, with HRs of 7.63 for > 3–999 copies/ml and 39.79 for ≥1000 copies/ml. However, the HRs decreased gradually after excluding NPC cases detected in the first 2 to 3 years and became statistically nonsignificant by excluding cases detected during the first 4 years. Conclusion Elevated plasma EBV DNA can predict NPC risk over 3 years. Monitoring plasma EBV DNA can be used as a complementary approach to EBV serological antibody-based screening for NPC.

Severe fever with thrombocytopenia syndrome virus (SFTSV) is a novel tick-borne bunyavirus that causes severe fever with thrombocytopenia syndrome (SFTS), with a high mortality rate of up to 30%. The envelope glycoproteins of SFTSV, glycoprotein N (Gn) and glycoprotein C (Gc), facilitate the recognition of host receptors and the process of membrane fusion, allowing the virus to enter host cells. We previously reported a monoclonal antibody, mAb 40C10, capable of neutralizing different genotypes of SFTSV and SFTSV-related viruses. However, the specific neutralization mechanism is poorly understood. In this study, we elucidated the high-resolution structure of the SFTSV Gn head domain in complex with mAb 40C10, confirming that the binding epitope in the domain I region of SFTSV Gn, and it represented that a novel binding epitope of SFTSV Gn was identified. Through in-depth structural and sequence analyses, we found that the binding sites of mAb 40C10 are relatively conserved among different genotypes of SFTSV and SFTSV-related Heartland virus and Guertu virus, elucidating the molecular mechanism underlying the broad-spectrum neutralizing activity of mAb 40C10. Furthermore, we humanized of mAb 40C10, which is originally of murine origin, to reduce its immunogenicity. The resulting nine humanized antibodies maintained potent affinity and neutralizing activity. One of the humanized antibodies exhibited neutralizing activity at picomolar IC50 values and demonstrated effective therapeutic and protective effects in a mouse infection model. These findings provide a novel target for the future development of SFTSV vaccines or drugs and establish a foundation for the research and development of antibody therapeutics for clinical applications. Author summary: Severe fever with thrombocytopenia syndrome virus (SFTSV) infection has emerged as a global public health issue, and its incidence is increasing annually. Neutralizing antibodies offer rapid and efficient therapeutic potential against viral infections. In this report, we elucidated the crystal structure of a highly effective and broad-spectrum murine neutralizing antibody, mAb 40C10, in complex with the SFTSV glycoprotein N (Gn) head domain. Through structural and sequence analyses, we revealed the molecular mechanism underlying the neutralization activity of mAb 40C10 and unveiled a new, potent, and broad-spectrum neutralizing epitope. Notably, this epitope is conserved across different genotypes of SFTSV and SFTSV-related viruses. The newly identified epitope provides valuable insights for reverse vaccine or drug design. Furthermore, we humanized mAb 40C10 and demonstrated the sustained efficacy of the humanized antibody in animal experiments, potentially advancing the development of clinical antibody therapeutics targeting SFTSV. [ABSTRACT FROM AUTHOR]

Solid oxide electrolysis cells (SOECs), displaying high current density and energy efficiency, have been proven to be an effective technique to electrochemically reduce CO2 into CO. However, the insufficiency of cathode activity and stability is a tricky problem to be addressed for SOECs. Hence, it is urgent to develop suitable cathode materials with excellent catalytic activity and stability for further practical application of SOECs. Herein, a reduced perovskite oxide, Pr0.35Sr0.6Fe0.7Cu0.2Mo0.1O3‐δ (PSFCM0.35), is developed as SOECs cathode to electrolyze CO2. After reduction in 10% H2/Ar, Cu and Fe nanoparticles are exsolved from the PSFCM0.35 lattice, resulting in a phase transformation from cubic perovskite to Ruddlesden–Popper (RP) perovskite with more oxygen vacancies. The exsolved metal nanoparticles are tightly attached to the perovskite substrate and afford more active sites to accelerate CO2 adsorption and dissociation on the cathode surface. The significantly strengthened CO2 adsorption capacity obtained after reduction is demonstrated by in situ Fourier transform‐infrared (FT‐IR) spectra. Symmetric cells with the reduced PSFCM0.35 (R‐PSFCM0.35) electrode exhibit a low polarization resistance of 0.43 Ω cm2 at 850 °C. Single electrolysis cells with the R‐PSFCM0.35 cathode display an outstanding current density of 2947 mA cm−2 at 850 °C and 1.6 V. In addition, the catalytic stability of the R‐PSFCM0.35 cathode is also proved by operating at 800 °C with an applied constant current density of 600 mA cm−2 for 100 h. [ABSTRACT FROM AUTHOR]

Objective To evaluate the improvement in the quality of early postoperative recovery in patients undergoing cardiac valve surgery with remimazolam-based fast - track anesthesia, and to provide a reference for the clinical optimization of fast - track anesthesia and Enhanced Recovery After Surgery (ERAS) protocols. Methods We selected elective surgery patients undergoing median sternotomy for cardiac valve replacement and/or repair under general anesthesia with extracorporeal circulation. Based on routine anesthesia assessment and fast-track anesthesia suitability assessment, a total of 228 patients were strictly enrolled according to the inclusion and exclusion criteria and randomly divided into two groups: the Remimazolam group (n = 114) and the Propofol group (n = 114) . Patients in the Remimazolam group were induced and maintained with remimazolam for anesthesia, while patients in the control group were administered propofol. We recorded the general information and surgical data of the patients, the QoR-15 scores before surgery (1 day preoperatively), 1 day postoperatively, 3 days postoperatively, and 1 day before discharge, as well as hemodynamic parameters at key time points after admission, the incidence of hypotension and bradycardia after anesthesia, the duration of surgery, anesthesia duration, postoperative mechanical ventilation time, ICU stay, postoperative hospital stay, and the incidence of perioperative cardiovascular adverse events and the incidence of early postoperative complications. Results There was no statistically significant difference in general data and QoR-15 scores between the two groups 1 day before surgery (P > 0.05) . The QoR-15 score of the Remimazolam group 1 day before discharge was higher than that of the Propofol group, with a statistically significant difference (P < 0.05), but the difference was less than the minimum clinically important difference, which is less than 8, indicating no significant clinical benefit. One minute after intubation and one minute after skin incision, the heart rate in the Propofol group slowed down and the Mean Arterial Pressure (MAP) significantly decreased, with a statistically significant difference between the groups (P < 0.05), there was no statistically significant difference in heart rate and MAP at other times. The incidence of intraoperative hypotension and bradycardia was lower in the Remimazolam group than in the Propofol group, with a statistically significant difference (P < 0.05) . The duration of postoperative mechanical ventilation, ICU stay, postoperative hospital stay, and the rate of re-intubation were all shorter in the Remimazolam group than in the Propofol group, and the success rate of fast-track anesthesia was higher in the Remimazolam group, with a statistically significant difference (P < 0.05) . There was no statistically significant difference in the incidence of perioperative complications between the two groups. Conclusions Compared with the commonly used intravenous anesthetic propofol, the remimazolam-based fast-track anesthesia regimen did not significantly improve the postoperative recovery quality scores in patients undergoing cardiac valve surgery. However, remimazolam had advantages in maintaining hemodynamic stability, increasing the success rate of fast-track anesthesia, shortening postoperative ICU stay and hospital stay, and is a viable intravenous anesthetic option for cardiac surgery patients. [ABSTRACT FROM AUTHOR]

IntroductionProspective evidence for herbal diet and nasopharyngeal carcinoma (NPC) development is absent. We therefore evaluated the associations of herbal soup and herbal tea with NPC in a prospective cohort study in southern China.MethodsBased on an NPC screening cohort established in 2008–2015, information on herbal diet consumption, potential confounding factors, and Epstein-Barr virus (EBV) antibody levels were collected from 10,179 individuals aged 30–69 years in Sihui city, southern China. Cox regression models were performed to examine herbal diet with NPC risk, and logistic regression models were used to examine herbal diet with EBV reactivation.ResultsDuring a median of 7.54 years of follow-up, 69 participants developed NPC. Herbal soup consumption was associated with decreased NPC risk, with HRs of 0.31 (95% confidence interval (CI): 0.15–0.62) for the highest intake frequency and 0.29 (95% CI: 0.16–0.51) for a longer duration. However, herbal tea was not significantly associated. Moreover, we identified herbal soup was inversely associated with EBV seropositivity among all the participants at baseline, with the adjusted ORs being 0.78 (95% CI: 0.65–0.93) for immunoglobulin A antibodies against EBV capsid antigens (VCA-IgA) and 0.76 (95% CI: 0.64–0.91) for nuclear antigen 1 (EBNA1-IgA) in those with the highest frequency and 0.70 (95% CI: 0.59–0.84) for VCA-IgA and 0.64 (95% CI: 0.54–0.77) for EBNA1-IgA in those with the longer duration. Inverse associations were also observed in non-NPC individuals.ConclusionsWith inhibition of EBV reactivation by plants, herbal soup could significantly decrease the risk of NPC in endemic areas.

Abstract Background The association between smoking and nasopharyngeal carcinoma (NPC) is still uncertain. The aim of this study was to validate smoking effect on NPC and explore if smoking can induce NPC by persistently reactivating EBV in long‐term based on a prospective cohort design. Methods A NPC screening cohort with 10 181 eligible residents in Sihui city, southern China was conducted from 2008 to 2015. The smoking habit was investigated through the trained interviewers and EBV antibodies (VCA‐IgA, EBNA1‐IgA) as screening markers were tested periodically. New NPC cases were identified through local cancer registry. Cox's regression model was used to estimate the adjusted hazard ratios (aHRs) of smoking on NPC incidence. In the non‐NPC participants, the associations between smoking and EBV seropositivity in different periods were assessed by logistic regression and generalized estimating equations (GEE). Results With a median of 7.54 years, 71 NPCs were diagnosed ≥1 year after recruitment. Compared with never smokers, the aHRs of developing NPC among ever smokers were 3.00 (95%CI: 1.46‐6.16). Stratified by sex, the HRs of ever smoking were 2.59 (95%CI: 1.07‐6.23) for male and 3.75 (95%CI: 1.25‐11.20) for female, respectively. Among the non‐NPC individuals, ever smoking was not only associated with EBV seropositivity at baseline, but also in the 3‐5 years of follow up, with adjusted odds ratios (aORs) of 1.68 (95%CI: 1.29‐2.18) for VCA‐IgA and 1.92 (95%CI: 1.42‐2.59) for EBNA1‐IgA. Among the smokers who were tested EBV antibodies at least twice, the similar results were obtained using GEE. Conclusion Smoking could significantly increase the long‐term risk of NPC in southern China, partly by persistently reactivating EBV.

Abstract Whether the association between body size or shape and nasopharyngeal carcinoma (NPC) risk exists or varies by age‐specific body size indicators is unclear. In a population‐based case–control study conducted in Southern China between 2010 and 2014, self‐reported height, weight, and body shape at age 20 and 10 years before interview were collected from 2448 histopathologically confirmed NPC cases and 2534 population‐based controls. Body mass index (BMI) was categorized according to the World Health Organization guidelines for Asian populations: underweight (

Objectives: Given the role of exposures related to residence in the development of nasopharyngeal carcinoma (NPC) has not been well explored, present study aims to investigate the magnitude and pattern of associations for NPC with lifelong residential exposures. Materials and Methods: We carried out a multi-center, population-based case-control study with 2533 incident NPC cases and 2597 randomly selected population controls in southern China between 2010 and 2014. We performed multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of NPC associated with residential exposures. Results: Compared with those living in a building over lifetime, risk of NPC was higher for individuals living in a cottage (OR: 1.56; 95% CI: 1.34–1.81) or in a boat (3.87; 2.07–7.21). NPC risk was also increased in individuals using wood (1.34; 1.03–1.75), coal (1.70; 1.17–2.47), or kerosene (3.58; 1.75–7.36) vs. using gas/electricity as cooking fuel; using well water (1.57; 1.34–1.83), river water (1.80; 1.47–2.21), or spring/pond/stream water (2.03; 1.70–2.41) vs. tap water for source of drinking water; living in houses with smaller-sized vs. larger windows in the bedroom (3.08; 2.46–3.86), hall (1.89; 1.55–2.31) or kitchen (1.67; 1.34–2.08); and increasing exposure to cooking smoke [(1.53; 1.20–1.94) for high exposure)] or burned incense [(1.59; 1.31–1.95) for daily use)]. Weighted Cox regression analysis corroborated these results. Conclusion: Poorer residential conditions and household air pollution are associated with an increased risk of NPC. Large-scale studies in other populations or longitudinal studies are warranted to further corroborate these findings.

ABSTRACT While Epstein-Barr virus (EBV) is the major cause of nasopharyngeal carcinoma (NPC), the value of the humoral immune response to EBV glycoproteins and NPC development remains unclear. Correlation between antiglycoprotein antibody levels, neutralization of EBV infectivity, and the risk of NPC requires systematic study. Here, we applied a cytometry-based method and enzyme-linked immunosorbent assay to measure neutralization of infectivity and antibody response to EBV glycoproteins (gH/gL, gB, gp350, and gp42) of plasma samples from 20 NPC cases and 20 high-risk and 20 low-risk healthy controls nested within a screening cohort in Sihui, southern China. We found that NPC cases have similar plasma neutralizing activity in both B cells and epithelial cells and EBV glycoprotein-specific IgA and IgG antibody levels compared with those of healthy controls. Significant correlations were observed between gH/gL IgG and gB IgG and the neutralizing ability against EBV infection of epithelial cells and B cells. These results indicate that a high level of glycoprotein antibodies may favor protection against primary EBV infection, instead of being low-risk biomarkers for NPC in long-term EBV-infected adults. In conclusion, this study provides novel insights into the humoral immune response to EBV infection and NPC development, providing valuable leads for future research that is important for prevention and treatment of EBV-related diseases. IMPORTANCE Epstein-Barr virus (EBV) is a human oncogenic gammaherpesvirus that infects over 90% of humans in the world and is causally associated with a spectrum of epithelial and B-cell malignancies such as nasopharyngeal carcinoma (NPC). A prophylactic vaccine against EBV is called for, but no approved vaccine is available yet. Therefore, EBV remains a major public health concern. To facilitate novel vaccines and therapeutics for NPC, it is of great importance to explore the impact of humoral immune response to EBV glycoproteins before the development of NPC. Therefore, in this study, we systematically assessed the correlation between antiglycoprotein antibody levels, neutralization of EBV infectivity, and the risk of NPC development. These results provide valuable information that will contribute to designing effective prevention and treatment strategies for EBV-related diseases such as NPC.

Cancer has become a major fatal disease in China. The relatively lower early detection rates for multiple cancer types have been one of the main reasons for a relatively lower cancer curative rate in China compared with the developed countries. To investigate trends in the early cancer detection rate over the past 5 years in a major city of China, 45,260 patients with newly diagnosed cancers of the nasopharynx, lung, thyroid, colorectum, liver, breast, uteral cervix, stomach, esophagus, blood, and kidney from 2016 to 2020 at Sun Yat-sen University Cancer Center were evaluated. The early detection rate (stage I disease) for all cancer types in combination significantly increased from 14.4 to 23.07%. Among the studied cancer types, a significant increase in stage I cancers was proportionally seen in cancers of the lung, thyroid, colorectum, and uterine cervix. While for cancers of the liver and stomach, a significant proportional increment was only observed when combining stage I and stage II diseases. No significant alteration in early cancer detection of the nasopharynx, breast, esophagus, blood, or kidney was observed. Three limitations of this present study include relatively small cohorts of cancer patients, relatively short observation periods, and limited sample representativeness. Further efforts are anticipated to validate our findings with larger patient cohorts from different parts of China and enhance early cancer detection rates by promoting public awareness, applying better health care policies, and improving insurance coverage and medical resources.

Abstract Background The association of circulating inflammation markers with nasopharyngeal carcinoma (NPC) is still largely unclear. This study aimed to comprehensively explore the relationship between circulating cytokine levels and the subsequent risk of NPC with a two-stage epidemiologic study in southern China. Methods The serum levels of 33 inflammatory cytokines were first measured in a hospital-based case–control study (150 NPC patients and 150 controls) using multiplex assay platforms. Marker levels were categorized into two or more groups based on the proportion of sample measurements that was above the lower limit of detection. Odds ratios (ORs) and 95% confidence intervals (CIs) relating the serum marker concentration to the risk of NPC were computed by multivariable logistic regression models. The associations were validated in 60 patients with NPC and 120 controls in a subsequent nested case–control study within a NPC screening trial. Potential interactions between serum cytokines and Epstein–Barr virus (EBV) relating to the risk of NPC were assessed using a likelihood ratio test. Results The levels of serum macrophage inflammatory protein (MIP)-1α and MIP-1β in the highest categories were associated with a decreased risk of NPC in both the case–control study (MIP-1α: OR = 0.49, 95% CI = 0.26–0.95; MIP-1β: OR = 0.47, 95% CI = 0.22–1.00) and the nested case–control study (MIP-1α: OR = 0.13, 95% CI = 0.03–0.62; MIP-1β: OR = 0.20, 95% CI = 0.04–0.94), compared with those in the lowest categories. Furthermore, individuals with lower levels of these two cytokine markers who were EBV seropositive presented with a largely higher risk of NPC compared with patients with higher levels who were EBV seronegative in both the case–control study (MIP-1α: OR = 16.28, 95% CI = 7.11–37.23; MIP-1β: OR = 12.86, 95% CI = 5.9–28.05) and the nested case–control study (MIP-1α: OR = 86.12, 95% CI = 10.58–701.03; MIP-1β: OR = 115.44, 95% CI = 13.92–957.73). Conclusions Decreased preclinical MIP-1α and MIP-1β levels might be associated with a subsequently increased risk of NPC. More mechanistic studies are required to fully understand this finding.

Epstein-Barr virus (EBV) C promoter (Cp) hypermethylation, a crucial factor for EBV latent infection of nasopharyngeal epithelial cells, has been recognized as a promising biomarker for nasopharyngeal carcinoma (NPC) detection. In this study, we develop a novel EBV Cp methylation quantification (E-CpMQ) assay and evaluate its diagnostic performance for NPC detection. A novel qPCR assay for simultaneous quantification of methylated- and unmethylated EBV Cp was developed by the combinational modification of MethyLight and QASM, with an innovative calibrator to improve the detection accuracy and consistency. The NP swab samples and synthetic standards were used for the analytical validation of the E-CpMQ. The diagnostic efficacy of the developed E-CpMQ assay was validated in 137 NPC patients and 137 non-NPC controls. The E-CpMQ assay can detect the EBV Cp methylation ratio in one reaction system under 10 copies with 100 % recognition specificity, which is highly correlated to pyrosequencing with a correlation coefficient over 0.99. The calibrated E-CpMQ assay reduces the coefficient of variation by an average of 55.5 % with a total variance of less than 0.06 units standard deviation (SD). Linear methylation ratio detection range from 4.76 to 99.01 %. The sensitivity and specificity of the E-CpMQ respectively are 96.4 % (95 % CI: 91.7–98.8 %), 89.8 % (95 % CI: 83.5–94.3 %). The developed E-CpMQ assay with a calibrator enables accurate and reproducible EBV Cp methylation ratio quantification and offers a sensitive, specific, cost-effective method for NPC early detection. [ABSTRACT FROM AUTHOR]