Humans ; Nasopharyngeal Neoplasms ; classification ; pathology ; Neoplasm Staging ; World Health Organization

Cancers of the upper aerodigestive tract (UADT) constitute 3.5-4% of all malignancies. Since the majority of cases are squamous cell carcinomas which are related with epidemiologic factors, a different pattern of UADT cancer might be present between the Western and Asian populations. We performed a pathology based statistical study on UADT cancers in Korean patients. Cases from Korea Cancer Center Hospital, from January 1, 1988 through December 31, 1998, were subjected to the study. Among 2,842 cases, epithelial malignancies accounted for 87.8%, with squamous cell carcinoma as the major type (76.5%). The larynx was the most commonly affected site (26%), followed by the oral cavity (25.1%), oropharynx (13%), nasopharynx (9%), hypopharynx (8.4%), paranasal sinuses (6.4%), nasal cavity (6%) and salivary glands (6.1%). The percentage of squamous cell carcinoma was highest (98.7%) at the hypopharynx, and lowest at the nasal cavity (42.3%), which showed the most diverse tumor entities. Korean patients with UADT cancers presented with a higher incidence of non-epidermoid malignancy including sarcoma (1.5%) and malignant melanoma (1.4%), and a higher frequency of involvement of the sinonasal tract, compared with the Western patients.
Head and Neck Neoplasms/classification/*pathology ; Humans ; Hypopharyngeal Neoplasms/classification/pathology ; Korea ; Laryngeal Neoplasms/classification/pathology ; Mouth Neoplasms/classification/pathology ; Nasal Cavity ; Nasopharyngeal Neoplasms/classification/pathology ; Oropharyngeal Neoplasms/classification/pathology ; Paranasal Sinus Neoplasms/classification/pathology ; Salivary Gland Neoplasms/classification/pathology

Adenocarcinoma ; pathology ; Carcinoma ; pathology ; Carcinoma, Squamous Cell ; pathology ; Humans ; Nasopharyngeal Neoplasms ; classification ; pathology ; World Health Organization

OBJECTIVE: To explore the effective treatment regimen for osteoradionecrosis of temporal bone. METHOD: Twenty-seven patients with massive osteoradionecrosis in temporal bone were included and retrospectively analyzed, in which, 15 cases received surgery and the other 12 cases adopted non-surgical treatment. RESULT: In the surgery group, three cases died one year postoperatively and died of massive hemorrhage due to internal carotid blowout. One case died four years after surgery without clear cause of death, and two cases were lost to follow up. Out of the nine survivors, the follow up period ranged from four months to eight years (one was followed up eight years, one was followed up over four years, four were followed up two-three years, one was followed up over one year, one was followed up nine months, and one was followed up four months, respectively). Patients classified as the type III received best outcome, and patients of type V and IV without invasion of the internal carotid artery received good surgical effects, while patients classified as the type IV with internal carotid artery invasion presented low survival rate. Two cases in the non-surgical group died of internal carotid rupture, and the other ten cases presented with repeated infection and expansion of the osteoradionecrosis lesion. CONCLUSION The new classification criteria is helpful in diagnosis of location of lesions,and can serve as a guide for clinical therapy. Massive osteoradionecrosis in temporal bone responded unfavorably to conservative treatment, compared to that, surgery can effectively control the expansion of the lesion and markedly improve patient quality of life. Long-term follow up is necessary because of the slow development of osteoradionecrosis after surgery.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; classification ; pathology ; surgery ; Osteoradionecrosis ; classification ; pathology ; surgery ; Retrospective Studies ; Temporal Bone ; pathology

Biopsy ; Carcinoma, Squamous Cell ; classification ; metabolism ; pathology ; Epithelial-Mesenchymal Transition ; Humans ; Immunohistochemistry ; Nasopharyngeal Neoplasms ; classification ; metabolism ; pathology ; Nasopharynx ; pathology ; RNA, Viral ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; Viral Matrix Proteins ; metabolism

OBJECTIVETo analyze the dysregulated genes among the differentially expressed genes in 41 nasopharyngeal biopsy samples and identify their protective transcriptional factors.

METHODSThe differentially expressed gene profiles were obtained by analyzing both types I and II nasopharyngeal carcinoma (NPC_I and NPC_II, respectively) using EXCEL and Bioinformatics tools. The transcriptional factors were further studied only when (1) the difference in the binding sites of the differentially expressed genes between NPC_I and NPC_II groups was statistically significant, (2) the expressions of the transcription factors were correlated with the gene expressions in the samples, and (3) the transcription factors affected at least 40% of the expression of the related genes.

RESULTSIn NPC_I samples, 80 transcription factors were found to be up-regulated, in which RUNX3, GATA3, NR3C1, NRF1, RXRA, SMAD7, TBP, and ZBTB6 were positive factors and HLF and MTF1 were negative factors, involved in the regulation of the genes in T cell receptor signaling pathway. No eligible transcription factors were found in association with down-regulated genes in NPC_I compared to NPC_II gene expression profiles.

CONCLUSIONSThe over-expressed genes in NPC_I are mainly related to immune responses, and we found 8 positive factors and 2 negative factors that regulate the genes in T cell receptor signaling pathway. The 10 transcription factors may serve as potential therapeutic targets for NPC_I. We failed to identify any transcription factors associated with down-regulated genes in NPC_I relative to NPC_II possibly as a result of multiple factors that affect the differential gene expressions in NPC_II including the transcription factors, DNA phosphorylation and modification, chromosome variation and environmental factors.

Carcinoma ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; Nasopharyngeal Neoplasms ; classification ; genetics ; metabolism ; pathology ; Receptors, Antigen, T-Cell ; genetics ; metabolism ; Signal Transduction ; Transcription Factors ; genetics ; metabolism

OBJECTIVETo investigate the Epstein-Barr virus (EBV) BamH I "f" variant in primary nasopharyngeal carcinoma (NPC) and its metastases in lymph nodes (LN).

METHODSIn situ hybridization was used to detect EBV-encoded small RNA (EBER) expression in 21 paired paraffin-embedded tissue from primary NPC and their lymph node metastases and 22 primary NPC without lymph node metastasis. PCR and restriction fragment length polymorphism (RFLP) assay were used to detect EBV BamH I "f" variant in all cases of NPCs, lymph node metastases and 50 cases of chronic inflammation of nasopharynx from Canton.

RESULTSAll cases of NPCs and their lymph node metastases showed EBER expression, indicating a high EBV-positive rate in Cantonese NPC patients. EBV BamH I "f" variant was found in 11 cases (52.4%, 11/21) of primary NPCs with LN metastasis, 12 cases (57.1%, 12/21) of the LN metastases, and 18 cases (81.8%, 18/22) of primary NPCs without LN metastasis. However, of the 50 cases of chronic inflammation of nasopharynx, only one case (2.1%, 1/47) demonstrated BamH I "f" variant. The frequency of BamH I "f" variant in NPC was therefore dramatically higher than that in chronic inflammation of nasopharynx. It is of note that atypical hyperplasia was observed in a few epithelial cells from the case of chronic inflammation of nasopharynx expressing BamH I "f" variant.

CONCLUSIONSThe frequency of EBV BamH I "f" variant in NPC is significantly higher than that in chronic inflammation of nasopharynx. It is the first demonstration that the BamH I "f" variant is also present in the LN metastases of NPC. The frequency of BamH I "f" variant in metastatic NPC of the lymph node is almost equal to that of primary NPCs.

Epithelial Cells ; drug effects ; Epstein-Barr Virus Infections ; classification ; complications ; virology ; Herpesvirus 4, Human ; classification ; genetics ; Humans ; In Situ Hybridization ; Lymph Nodes ; drug effects ; pathology ; virology ; Lymphatic Metastasis ; physiopathology ; Nasopharyngeal Neoplasms ; genetics ; pathology ; virology ; Nasopharynx ; virology ; RNA, Viral ; analysis ; pharmacology

BACKGROUND AND OBJECTIVETraditional Chinese medicine (TCM) is a well established and time-honored practice in China, employing syndrome differentiation as a basis for the treatment of disease. According to different TCM syndrome typing findings, combining modern medical methods with TCM approaches can improve the quality of life and comprehensive effect on patients with nasopharyngeal carcinoma (NPC). This study investigated the relationship between TCM syndrome typing and imaging characterization to radiosensitivity as to provide objective evidence for the integration of Chinese and modern medical approaches in the treatment of NPC.

METHODSPrior to treatment, TCM syndrome typing, computed tomography (CT) and magnetic resonance imaging (MRI) were performed on 147 patients pathologically classified with NPC. The status of tumor remission was radiologically evaluated at accumulated doses of 20 Gy, 40 Gy and 60 Gy, and at 3 months after completion of radiotherapy. Statistical results were analyzed by the Friedman and K-W test procedures.

RESULTSPrior to treatment, TCM syndrome typing of NPC included Lung Heat, Blood Stasis, Phlegm Congealment and Blood Stasis-Phlegm Congealment. Lung Heat typing accounted for the highest proportion at 34.7% (51/147), followed by Phlegm Congealment at 32.7% (48/147), Blood Stasis at 17.0% (25/147) and Blood Stasis-Phlegm Congealment at 15.7% (23/147). Radiological imaging demonstrated a higher incidence of cervical lymph node metastases in Phlegm Congealment and Blood Stasis-Phlegm Congealment types (P<0.05), while Blood Stasis and Blood Stasis-Phlegm Congealment types were more prone to skull base invasion (P<0.05). Residual tumor size was larger in Blood Stasis and Blood Stasis-Phlegm Congealment types than in Lung Heat and Phlegm Congealment types after 3 months of treatment (P<0.05).

CONCLUSIONSDifferent radiological manifestations were observed in TCM syndrome typed NPC patients, with lesser radiosensitivity demonstrated in the Blood Stasis and the Blood Stasis-Phlegm Congealment types relative to the Lung Heat and Phlegm Congealment types.

Adolescent ; Adult ; Aged ; Child ; Diagnosis, Differential ; Female ; Humans ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nasopharyngeal Neoplasms ; classification ; diagnosis ; diagnostic imaging ; radiotherapy ; Neoplasm Invasiveness ; Neoplasm, Residual ; pathology ; Radiation Tolerance ; Skull Base ; pathology ; Tomography, X-Ray Computed ; Young Adult