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Pandit S, Sapkota S, Adhikari A, Karki P, Yadav D, Shrestha R, Yogal R, Chalise S, Pathak R, Jha AK. Ethno-geographic distribution and histopathological classification of nasopharyngeal carcinoma in a single center in Nepal. PLoS One 2024; 19:e0304371. [PMID: 38820402 PMCID: PMC11142571 DOI: 10.1371/journal.pone.0304371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 05/10/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION Nasopharyngeal carcinoma (NPC) shows geographic and ethnic variation with specific etiopathogenesis. This study characterized the distribution of NPC patients stratified by ethnicity, geography, and histology in a tertiary-level cancer center in Nepal. METHODS A descriptive retrospective study was designed to analyze NPC cases from different regions among patients visiting the hospital from 2016 to 2021. Demographic and clinical information was obtained from medical records. Ethical approval was granted by the Nepal Health Research Council (NHRC). Data analyses and visualization were carried out with R software. RESULTS During the six-year period, a total of 65 individuals were diagnosed with NPC, comprising 42 males and 23 females. Patient median age was 43 years (range 11-85 years). A bimodal age distribution of cases was observed with peaks in patients aged 30-39 years and 50-59 years. Of the NPC patients studied, 29 were from Koshi Province, with 7 cases from Ilam district and 6 cases from Morang district. There were 18 patients in Bagmati Province, and Kathmandu district had the highest number of cases within this region, with 8 patients. The highest proportion of cases were observed among patients of Janajati ethnicity (60%), including Rai, Limbu, and Sherpa people. Histologically, undifferentiated non-keratinizing NPC was the most commonly observed subtype, accounting for 43.1% of cases, followed by 20% differentiated non-keratinizing NPC and 4.6% keratinizing NPC across the entire sample population. The majority of patients (75.3%) were diagnosed at an advanced stage (stage III or IV) with none diagnosed at stage I. CONCLUSIONS In our study, most cases of NPC occurred in patients from provinces in eastern Nepal (Koshi province), and of the Janajati ethnic community. The most common histological subtype was undifferentiated non-keratinizing carcinoma. Further epidemiological studies could address differences in prevalence and the challenge of late presentation of NPC patients in Nepal.
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Affiliation(s)
- Subhas Pandit
- Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Simit Sapkota
- Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Abish Adhikari
- Department of Radiation Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Prakriti Karki
- Department of Research, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Deepak Yadav
- Department of Head and Neck Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Roshani Shrestha
- Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Rijendra Yogal
- Department of Head and Neck Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Sanat Chalise
- Department of Pathology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Rakesh Pathak
- Department of Pathology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
| | - Anjani Kumar Jha
- Department of Radiation Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Nepal
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Wang Y, Koh KK, Chua E, Kiong KL, Kwan YH, Charn TC. The association between chronic sinonasal inflammation and nasopharyngeal carcinoma - A systematic review and meta-analysis. Am J Otolaryngol 2024; 45:104206. [PMID: 38141564 DOI: 10.1016/j.amjoto.2023.104206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 12/25/2023]
Abstract
PURPOSE There has been mounting evidence that inflammation is a key risk factor towards the development of certain cancers. Past studies have shown associations between nasopharyngeal carcinoma (NPC) and sinonasal tract inflammation. We aim to conduct a review and meta-analysis on the association between NPC and chronic sinus inflammation. MATERIALS AND METHODS We conducted a meta-analysis, searching 4 international databases from 1 January 1973 to 28 March 2022 for studies reporting on sinonasal inflammation and NPC in adult patients (>18 years old). We included cohort, case-control or cross-sectional studies. These studies must examine the association between a prior history of sinonasal inflammation and the risk of developing NPC. The outcome is the incidence of NPC in patients who had prior sinonasal inflammation. RESULTS 8 studies (8245 NPC; 1,036,087 non-NPC) were included. The overall odds ratio (OR) of patients having NPC after reporting sinonasal inflammation was 1.81 (95 % CI 1.73-1.89). Of note, chronic rhinosinusitis (CRS) (OR of 1.78 (95 %-CI: 1.68-1.90)) was more closely associated with an increased risk of NPC, as compared to allergic rhinitis (AR) (OR of 1.60 (95 %-CI: 1.52-1.68)). CONCLUSION Chronic sinonasal inflammation is significantly associated with NPC in this systemic review and meta-analysis. The true cause-effect relationship and the potential effects of targeted screening need to be explored thoroughly with large scale prospective studies.
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Affiliation(s)
- Yuxing Wang
- Ministry of Health, MOH Holdings, Singapore 099253.
| | | | - Elizabeth Chua
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
| | - Kimberley Liqin Kiong
- Department of Otolaryngology, Singapore General Hospital, Singapore 169608, Singapore; Department of Otolaryngology, Sengkang General Hospital, Singapore 544886, Singapore.
| | - Yu Heng Kwan
- Internal Medicine, SingHealth Residency, Singapore; Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore 117559, Singapore; Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore.
| | - Tze Choong Charn
- Department of Otolaryngology, Singapore General Hospital, Singapore 169608, Singapore; Department of Otolaryngology, Sengkang General Hospital, Singapore 544886, Singapore.
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Yamauchi M, Sato Y, Ishida T, Minesaki A, Shimazaki E, Kuratomi Y. Cetuximab Plus Concurrent Radiotherapy in Patients With Nasopharyngeal Carcinoma. In Vivo 2023; 37:2224-2228. [PMID: 37652522 PMCID: PMC10500510 DOI: 10.21873/invivo.13323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM Several reports have evaluated the efficacy and safety of concurrent radiotherapy with cetuximab (BRT) in patients with nasopharyngeal carcinoma (NPC). Combination therapy with cetuximab can be a treatment option for NPC. Although clinical data regarding the efficacy and safety of BRT without induction chemotherapy (ICT) or adjuvant chemotherapy is essential for the development of new therapeutic strategies, such data are rarely reported. PATIENTS AND METHODS We retrospectively investigated a series of patients with NPC treated in our institution to evaluate the efficacy and safety of BRT. Eleven patients with newly diagnosed NPC were identified from an inpatient database from July 2015 to April 2018. Seven patients who received BRT were reviewed. RESULTS All patients completed BRT without cessation of treatment. Six (85.7%) patients achieved a complete response and one (14.3%) achieved stable disease. The response rate was 85.7%. All patients with ≤T3 disease achieved a complete response. Both patients with T3 disease developed local recurrence, and one of the four patients with T1-2 disease developed distant metastases. The 1- and 3-year overall survival rates were 85.7% and 47.6%, respectively. The most common adverse events (AEs) were pharyngeal mucositis (100%), radiation dermatitis (100%), anorexia (28.6%), weight loss (28.6%), acneiform rash (28.6%), and dry mouth (28.6%). Grade 3 AEs were pharyngeal mucositis (42.9%), radiation dermatitis (28.6%), and anorexia (14.3%). No grade 4/5 AEs were observed. CONCLUSION BRT for NPC was tolerable, but our findings suggest that BRT without induction chemotherapy or adjuvant chemotherapy is insufficient at least for ≥T3 disease.
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Affiliation(s)
- Moriyasu Yamauchi
- Department of Otolaryngology - Head and Neck Surgery, Saga University Faculty of Medicine, Nabeshima, Japan
| | - Yuki Sato
- Department of Otolaryngology - Head and Neck Surgery, Saga University Faculty of Medicine, Nabeshima, Japan
| | - Tomoya Ishida
- Department of Otolaryngology - Head and Neck Surgery, Saga University Faculty of Medicine, Nabeshima, Japan
| | - Akimichi Minesaki
- Department of Otolaryngology - Head and Neck Surgery, Saga University Faculty of Medicine, Nabeshima, Japan
| | - Eriko Shimazaki
- Department of Otolaryngology - Head and Neck Surgery, Saga University Faculty of Medicine, Nabeshima, Japan
| | - Yuichiro Kuratomi
- Department of Otolaryngology - Head and Neck Surgery, Saga University Faculty of Medicine, Nabeshima, Japan
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Shen T, Cai W, Li T, Yu D, Ren C, Yu J. Impact of primary site on survival in patients with nasopharyngeal carcinoma from 2004 to 2015. Front Surg 2022; 9:1001849. [PMID: 36406355 PMCID: PMC9671952 DOI: 10.3389/fsurg.2022.1001849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Background Nasopharynx carcinoma (NPC) is the most common malignant tumor of the nasopharynx. Many studies have shown some factors related with the prognosis of NPC patients. Our study aims to evaluate the differences of prognosis between initial and second primary NPC. Material and methods The Surveillance, Epidemiology, and End Results (SEER) program was used to perform the population-based analysis in NPC patients who were newly diagnosed between 2004 and 2015. Kaplan-Meier and Cox regressions were used to evaluate the effects of primary site on the overall survival (OS), as well as the cancer-specific survival (CSS). Results Our study included 5,012 NPC patients: 4,474 initial primary NPC patients and 5,38 s primary NPC patients. Significant differences were observed in sex, age at diagnosis, race, median household income, histological type, American Joint Committee on Cancer (AJCC) stage, N-stage, radiation treatment and chemotherapy between patients with initial and second NPC (P < 0.05). Moreover, the patients with second NPC had longer survival months. In addition, radiation and chemotherapy were recommended both in first and second primary NPC patients. Conclusion Worse prognosis was observed in patients with second primary NPC compared with those with primary NPC in all subgroups of AJCC stage and age at diagnosis.
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Affiliation(s)
- Tianyi Shen
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Wenting Cai
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Tingting Li
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Donghui Yu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Chengda Ren
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Jing Yu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
- Department of Ophthalmology, The Third People’s Hospital of Bengbu, Bengbu, China
- Correspondence: Jing Yu
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Sellami M, Kallel S, Ben Ayed M, Mellouli M, Boudawara TS, Mnejja M, Hammami B, Achour I, Charfeddine I. Nasopharyngeal Metastasis from Breast Carcinoma: A Case Report and a Review of the Literature. EAR, NOSE & THROAT JOURNAL 2022:1455613221119047. [PMID: 35943955 DOI: 10.1177/01455613221119047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Metastasis to the nasopharynx is a rare clinical entity. Breast carcinoma is one of the primary tumors that can be responsible for a nasopharyngeal metastasis, which is an extremely rare occurrence. We report the case of a 50-year-old woman with a history of a confirmed breast carcinoma under chemotherapy who presented to our department with a unilateral hearing loss and tinnitus. Nasal endoscopy revealed a small bulging mass at the posterior wall of the nasopharynx. The biopsy of the lesion showed an infiltration of the nasopharyngeal mucosa by a mammary adenocarcinoma that was positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2. Computed tomography scan revealed a thickening of the nasopharyngeal mucosa, a pleural and pericardial effusion and diffused secondary bone lesions. The patient received chemotherapy. Control revealed a partial regression of the nasopharyngeal mass. The patient is still under chemotherapy.
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Affiliation(s)
- Moncef Sellami
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Souha Kallel
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Mariam Ben Ayed
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Manel Mellouli
- Sfax Medical School, University of Sfax, Sfax, Tunisia
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Tahya Sellami Boudawara
- Sfax Medical School, University of Sfax, Sfax, Tunisia
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Malek Mnejja
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Bouthaina Hammami
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Imen Achour
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Ilhem Charfeddine
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
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Kouka M, Engelhardt M, Wittig A, Schultze-Mosgau S, Ernst T, Guntinas-Lichius O. No impact of time to treatment initiation for head and neck cancer in a tertiary university center in 2003, 2008 and 2013. Eur Arch Otorhinolaryngol 2022; 279:4549-4560. [PMID: 35488907 PMCID: PMC9363340 DOI: 10.1007/s00405-022-07392-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 04/05/2022] [Indexed: 11/30/2022]
Abstract
Background This retrospective study investigated factors influencing time to treatment initiation (TTI) and the influence of TTI on overall survival (OS) of primary head and neck cancer (HNC) patients in cohorts from 2003, 2008 and 2013. Methods Two hundred and ninenty seven patients (78.8% men; median age: 62 years) were included. Kaplan–Meier analyses and multivariate Cox regression were performed to investigate OS. Results Mean times to treatment initiation (TTI) of 2003, 2008 and 2013 were 17.11 ± 18.00, 30.26 ± 30.08 and 17.30 ± 37.04 days, respectively. TTI for patients with T3/T4 tumors was higher than for T1/T2 (p = 0.010). In univariable analysis on OS, TTI > 5 days showed lower OS (p = 0.047). In multivariate analysis, longer TTI had no influence on lower OS [hazard ratio (HR) 1.236; 95% CI 0.852–1.791; p = 0.264], but male gender [HR 2.342; 95% CI 1.229–4.466; p = 0.010], increased age [HR 1.026; 95% CI 1.008–1.045; p = 0.005], M1 [HR 5.823; 95% CI 2.252–15.058; p = 0.003], hypopharynx tumor [HR 2.508; 95% CI 1.571–4.003; p < 0.001] and oral cavity tumor [HR 1.712; CI 1.101–2.661; p = 0.017]. The year of treatment showed no significant effect on OS. Conclusion Median TTI seemed to be very short compared to other studies. There was no clear trend in the impact of TTI on OS from 2003 to 2013. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-022-07392-w.
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Affiliation(s)
- Mussab Kouka
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Max Engelhardt
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Andrea Wittig
- Department of Radiotherapy and Radiation Oncology, Jena University Hospital, Jena, Germany
| | - Stefan Schultze-Mosgau
- Department of Oromaxillofacial Surgery and Plastic Surgery, Jena University Hospital, Jena, Germany
| | - Thomas Ernst
- University Tumor Center, Jena University Hospital, Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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Song Y, Cheng W, Li H, Liu X. The global, regional, national burden of nasopharyngeal cancer and its attributable risk factors (1990-2019) and predictions to 2035. Cancer Med 2022; 11:4310-4320. [PMID: 35475595 DOI: 10.1002/cam4.4783] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/10/2022] [Accepted: 04/19/2022] [Indexed: 12/24/2022] Open
Abstract
We aim to report the latest incidence, mortality, and disability-adjusted life-years (DALYs) between 1990 and 2019, by age, sex, sociodemographic index (SDI), and provide predictions to 2035. We use estimates from Global Burden of Disease, Injuries, and Risk Factors Study 2019 to analyze the incidence, mortality, and DALYs. All the estimates were shown as counts and age-standardized rates (ASR). In 2019, there were more than 176,501 (156,046 to 199,917) incidence cases, with ASRs of 2.1 (1.9 to 2.4). Nasopharyngeal cancer (NPC) accounted for 71,610 (65,442 to 77,625) deaths, with ASRs of 0.9 (0.8 to 0.9). NPC was also responsible for 2.34 million (2,139,753 to 2,536,657) DALYs, with ASRs of 28.0 (25.7 to 30.4). The count of all the new cases increased from 1990 to 2019. At the regional level, the highest age-standardized incidence rates were found in East Asia, the highest age-standardized death and DALY rates were shown in Southeast Asia. At the national level, the age-standardized incidence rates were highest in Singapore, and the age-standardized death and DALY rates were highest in Malaysia. The total numbers and rates of all the estimates were significantly higher among males than females across most of the age groups. The considerable burden of NPC was attributable to alcohol use, smoking, and occupational exposure to formaldehyde. A total of six GBD regions and 88 countries are projected to experience an increase in NPC ASRs between 2019 and 2035, respectively. Despite the current decline in age-standardized mortality and DALY rates globally, the age-standardized incidence rate has increased from 1990 to 2019, and continues to increase between 2020 and 2035, indicating that nasopharyngeal cancer remains a major health challenge worldwide. Prevention strategies should focus on modifiable risk factors, especially among males in East Asia.
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Affiliation(s)
- Yexun Song
- Department of Otolaryngology-Head Neck Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wenwei Cheng
- The Third Xiangya Hospital of Central South University, Changsha, China.,Xiangya School of Public Health, Central South University, Changsha, China
| | - Heqing Li
- Department of Otolaryngology-Head Neck Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Xiajing Liu
- Graduate School of Guilin Medical University, Guilin, China
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Associations between ALDH Genetic Variants, Alcohol Consumption, and the Risk of Nasopharyngeal Carcinoma in an East Asian Population. Genes (Basel) 2021; 12:genes12101547. [PMID: 34680942 PMCID: PMC8535421 DOI: 10.3390/genes12101547] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022] Open
Abstract
Nasopharyngeal carcinoma (NPC) and alcohol flush syndrome are thought to be strongly influenced by genetic factors and are highly prevalent amongst East Asians. Diminished activity of aldehyde dehydrogenase (ALDH), a major enzyme in the alcohol-metabolizing pathway, causes the flushing syndrome associated with alcoholic consumption. The genetic effect of ALDH isoforms on NPC is unknown. We therefore investigated the association between the genetic polymorphisms of all 19 ALDH isoforms and NPC among 458 patients with NPC and 1672 age- and gender-matched healthy controls in Taiwan. Single-nucleotide polymorphisms (SNPs) located between the 40,000 base pairs upstream and downstream of the 19 ALDH isoform coding regions were collected from two genome-wise association studies conducted in Taiwan and from the Taiwan Biobank. Thirteen SNPs located on ALDH4A1, ALDH18A1, ALDH3B2, ALDH1L2, ALDH1A2, and ALDH2 Glu487Lys (rs671) were associated with NPC susceptibility. Stratification by alcohol status revealed a cumulative risk effect for NPC amongst drinkers and non-drinkers, with odds ratios of 4.89 (95% confidence interval 2.15–11.08) and 3.57 (1.97–6.47), respectively. A synergistic effect was observed between SNPs and alcohol. This study is the first to report associations between genetic variants in 19 ALDH isoforms, their interaction with alcohol consumption and NPC in an East Asian population.
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Chang ET, Ye W, Zeng YX, Adami HO. The Evolving Epidemiology of Nasopharyngeal Carcinoma. Cancer Epidemiol Biomarkers Prev 2021; 30:1035-1047. [PMID: 33849968 DOI: 10.1158/1055-9965.epi-20-1702] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/15/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The epidemiology of nasopharyngeal carcinoma (NPC) has long been a source of fascination due to the malignancy's striking geographic distribution, the involvement of the oncogenic Epstein-Barr virus (EBV), the unique association with intake of Chinese-style salt-preserved fish, and etiologic heterogeneity by histologic subtype. METHODS This review summarizes the current epidemiologic literature on NPC, highlighting recent results from our population-based case-control study in southern China. RESULTS Findings from our case-control study provide new insight into the epidemiology of NPC, including a diminished role of Chinese-style salt-preserved fish, a profound impact of EBV genetic sequence variation, modest positive associations with passive smoking and household air pollution, and possible effects of oral health and the oral microbiome. Recent findings from other studies include a protective association with infectious mononucleosis, suggesting a causal role of early EBV infection; familial risk conferred by shared genetic variation in the host antibody-mediated immune response to EBV infection; and an unclear association with occupational exposure to formaldehyde. CONCLUSIONS To shed further light on the interplay of environmental, genetic, and viral causes of NPC, large pooled studies must accumulate sufficient cases with detailed exposure data. IMPACT New epidemiologic findings have reshaped the causal model for NPC.
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Affiliation(s)
- Ellen T Chang
- Center for Health Sciences, Exponent, Inc., Menlo Park, California.
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Yi-Xin Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Beijing Hospital, Beijing, P.R. China
| | - Hans-Olov Adami
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway
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10
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Feng R, Chang ET, Liu Q, Cai Y, Zhang Z, Chen G, Huang QH, Xie SH, Cao SM, Zhang Y, Yun JP, Jia WH, Zheng Y, Liao J, Chen Y, Huang T, Lin L, Ernberg I, Huang G, Zeng YX, Adami HO, Ye W. Intake of Alcohol and Tea and Risk of Nasopharyngeal Carcinoma: A Population-Based Case-Control Study in Southern China. Cancer Epidemiol Biomarkers Prev 2020; 30:545-553. [PMID: 33303643 DOI: 10.1158/1055-9965.epi-20-1244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/16/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The potential effect of alcohol or tea intake on the risk of nasopharyngeal carcinoma (NPC) remains controversial. METHODS In a population-based case-control study in southern China, we assessed alcohol or tea intake from 2,441 histopathologically confirmed NPC cases and 2,546 controls. We calculated mean daily ethanol (g/day) and tea intake (mL/day). Fully adjusted ORs with 95% confidence intervals (CI) were estimated using logistic regression; potential dose-response trends were evaluated using restricted cubic spline analysis. RESULTS Compared with nondrinkers, no significantly increased NPC risk in men was observed among current alcohol drinkers overall (OR, 1.08; 95% CI, 0.93-1.25), nor among current heavy drinkers (OR for ≥90 g/day ethanol vs. none, 1.32; 95% CI, 0.95-1.84) or former alcohol drinkers. Current tea drinking was associated with a decreased NPC risk (OR, 0.73; 95% CI, 0.64-0.84). Compared with never drinkers, those with the low first three quintiles of mean daily current intake of tea were at significantly lower NPC risk (OR, 0.53, 0.68, and 0.65, respectively), but not significant for the next two quintiles. Current daily tea intake had a significant nonlinear dose-response relation with NPC risk. CONCLUSIONS Our study suggests no significant association between alcohol and NPC risk. Tea drinking may moderately reduce NPC risk, but the lack of a monotonic dose-response association complicates causal inference. IMPACT Tea drinking might be a healthy habit for preventing NPC. More studies on biological mechanisms that may link tea with NPC risk are needed.
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Affiliation(s)
- Ruimei Feng
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Epidemiology and Health Statistics and Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Ellen T Chang
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China.,Exponent, Inc., Center for Health Sciences, Menlo Park, California.,Stanford Cancer Institute, Stanford, California
| | - Qing Liu
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yonglin Cai
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, China.,Wuzhou Health System Key Laboratory for Nasopharyngeal Carcinoma Etiology and Molecular Mechanism, Wuzhou, China
| | - Zhe Zhang
- Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Guomin Chen
- State Key Laboratory for Infectious Diseases Prevention and Control, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Shang-Hang Xie
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Su-Mei Cao
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yu Zhang
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jing-Ping Yun
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wei-Hua Jia
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yuming Zheng
- Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, China.,Wuzhou Health System Key Laboratory for Nasopharyngeal Carcinoma Etiology and Molecular Mechanism, Wuzhou, China
| | - Jian Liao
- Cangwu Institute for Nasopharyngeal Carcinoma Control and Prevention, Wuzhou, China
| | - Yufeng Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tingting Huang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Longde Lin
- Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Ingemar Ernberg
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Guangwu Huang
- Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Yi-Xin Zeng
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China.,Beijing Hospital, Beijing, China
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Clinical Effectiveness Group, Institute of Health University of Oslo, Oslo, Norway
| | - Weimin Ye
- Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China. .,State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Epidemiology and Health Statistics and Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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11
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Bakkalci D, Jia Y, Winter JR, Lewis JE, Taylor GS, Stagg HR. Risk factors for Epstein Barr virus-associated cancers: a systematic review, critical appraisal, and mapping of the epidemiological evidence. J Glob Health 2020; 10:010405. [PMID: 32257153 PMCID: PMC7125417 DOI: 10.7189/jogh.10.010405] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Epstein Barr Virus (EBV) infects 90%-95% of all adults globally and causes ~ 1% of all cancers. Differing proportions of Burkitt's lymphoma (BL), gastric carcinoma (GC), Hodgkin's lymphoma (HL) and nasopharyngeal carcinoma (NPC) are associated with EBV. We sought to systematically review the global epidemiological evidence for risk factors that (in addition to EBV) contribute to the development of the EBV-associated forms of these cancers, assess the quality of the evidence, and compare and contrast the cancers. METHODS MEDLINE, Embase and Web of Science were searched for studies of risk factors for EBV-associated BL, GC, HL and NPC without language or temporal restrictions. Studies were excluded if there was no cancer-free comparator group or where analyses of risk factors were inadequately documented. After screening and reference list searching, data were extracted into standardised spreadsheets and quality assessed. Due to heterogeneity, a narrative synthesis was undertaken. RESULTS 9916 hits were retrieved. 271 papers were retained: two BL, 24 HL, one GC and 244 NPC. The majority of studies were from China, North America and Western Europe. Risk factors were categorised as dietary, environmental/non-dietary, human genetic, and infection and clinical. Anti-EBV antibody load was associated with EBV-associated GC and BL. Although the evidence could be inconsistent, HLA-A alleles, smoking, infectious mononucleosis and potentially other infections were risk factors for EBV-associated HL. Rancid dairy products; anti-EBV antibody and EBV DNA load; history of chronic ear, nose and/or throat conditions; herbal medicine use; family history; and human genetics were risk factors for NPC. Fresh fruit and vegetable and tea consumption may be protective against NPC. CONCLUSIONS Many epidemiological studies of risk factors in addition to EBV for the EBV-associated forms of BL, GC, HL and NPC have been undertaken, but there is a dearth of evidence for GC and BL. Available evidence is of variable quality. The aetiology of EBV-associated cancers likely results from a complex intersection of genetic, clinical, environmental and dietary factors, which is difficult to assess with observational studies. Large, carefully designed, studies need to be strategically undertaken to harmonise and clarify the evidence. REGISTRATION PROSPERO CRD42017059806.
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Affiliation(s)
- Deniz Bakkalci
- Institute for Global Health, University College London, London, UK
- Joint first authors, listed alphabetically
| | - Yumeng Jia
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Joint first authors, listed alphabetically
| | - Joanne R Winter
- Institute for Global Health, University College London, London, UK
- Joint first authors, listed alphabetically
| | - Joanna Ea Lewis
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Graham S Taylor
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Joint senior authors
| | - Helen R Stagg
- Institute for Global Health, University College London, London, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Joint senior authors
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12
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Du T, Chen K, Zheng S, Bao M, Huang Y, Wu K. Association Between Alcohol Consumption and Risk of Nasopharyngeal Carcinoma: A Comprehensive Meta-Analysis of Epidemiological Studies. Alcohol Clin Exp Res 2019; 43:2262-2273. [PMID: 31436869 DOI: 10.1111/acer.14184] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 08/09/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Alcohol consumption is increasing all over the world, but whether it is an independent factor affecting the occurrence of nasopharyngeal carcinoma (NPC) is inconsistent in many studies. We aimed to explore the association between alcohol consumption and NPC risk by integrating existing evidence in a meta-analysis. METHODS We searched for relevant articles published up to August 2018 in PubMed, Cochrane Library, Web of Science, and China National Knowledge infrastructure (CNKI). The Newcastle-Ottawa scale was used to assess the quality of the included studies. Odds ratios (ORs) or relative risks were pooled to estimate the associations between alcohol consumption and NPC risk. RESULTS The meta-analysis of cohort studies showed no significant association between alcohol consumption and NPC, but pooled results from case-control studies indicated that ever drinking increased the probability of NPC versus nondrinking (OR = 1.10; 95% confidence interval [CI]: 1.01, 1.19). As compared with nondrinkers, high-frequency drinking (≥7 times/wk) increased the NPC probability (OR = 1.29; 95% CI: 1.05, 1.53) and low-frequency drinking (<7 times/wk) decreased the probability (OR = 0.77; 95% CI: 0.60, 0.94), as did shorter duration of drinking (<20 years) (OR = 0.64; 95% CI: 0.49, 0.79). On subgroup analyses, significant pooled results were observed for studies with high quality, with hospital-based controls and with adjustment for confounding factors, smoking, age, and sex. CONCLUSIONS The risk of NPC may increase with alcohol consumption. Ever drinking increased the risk versus nondrinking. Additionally, high-frequency drinking increased the risk, but low-frequency drinking decreased it to some extent. Further intensive studies based on well-designed methods are needed to examine the association.
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Affiliation(s)
- Taifeng Du
- From the, Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Kangkang Chen
- From the, Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Shukai Zheng
- From the, Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Mian Bao
- From the, Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Yuanni Huang
- From the, Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Kusheng Wu
- From the, Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, Guangdong Province, China
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13
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Lang J, Hu C, Lu T, Pan J, Lin T. Chinese expert consensus on diagnosis and treatment of nasopharyngeal carcinoma: evidence from current practice and future perspectives. Cancer Manag Res 2019; 11:6365-6376. [PMID: 31372041 PMCID: PMC6628961 DOI: 10.2147/cmar.s197544] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 05/16/2019] [Indexed: 12/22/2022] Open
Abstract
Nasopharyngeal carcinoma (NPC) is a rare type of head and neck cancer, with a higher incidence reported only in Southeast Asia and Northern Africa. Owing to the rarity of NPC occurrence, no internationally accepted consensus or guideline for its diagnosis and treatment is available. Based on the current evidences and practices, the Chinese experts on multidisciplinary diagnosis and treatment of NPC were designated to develop a national consensus for the treatment strategy of NPC. In this consensus, we report the development for improving the treatment efficacy and quality of life of NPC patients in China. The consensus also describes and recommends the role of multidisciplinary management approach in the management of NPC. A multidisciplinary team should include experts from different domains who can cater to the individualized needs of patients with NPC in a much more efficient manner. In addition, the team may also play a key role in developing guiding principles for future research, contributing to the improvement in the management of NPC.
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Affiliation(s)
- Jinyi Lang
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Chaosu Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Taixiang Lu
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Jianji Pan
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, People's Republic of China
| | - Tongyu Lin
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, and Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China
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14
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Zhang J, Shen Z, Liu H, Liu S, Shu W. Diagnostic potential of methylated DAPK in brushing samples of nasopharyngeal carcinoma. Cancer Manag Res 2018; 10:2953-2964. [PMID: 30214290 PMCID: PMC6118259 DOI: 10.2147/cmar.s171796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background The death-associated protein kinase (DAPK) gene is an important member of the apoptotic pathway and is inactivated by abnormal methylation in numerous cancers, including nasopharyngeal carcinoma (NPC). However, the diagnostic value of DAPK methylation in brushing samples and tissue samples of NPC remains unclear. Methods We conducted a systematic meta-analysis based on 17 studies (including 386 tissue cases, 233 brushing cases, and 296 blood cases). Results Our results revealed an association between methylated DAPK and increased risk of NPC in blood, brushing, and tissue samples. In addition, the comparison of the pooled sensitivity, specificity, and area under the curve of methylated DAPK in brushing and tissue samples demonstrated the non-inferior effectiveness of methylated DAPK in brushing samples to monitor the development of NPC.
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Affiliation(s)
- Jian Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, People's Republic of China
| | - Zhisen Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, People's Republic of China
| | - Huigao Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Zhenhai Longsai Hospital, Ningbo, People's Republic of China
| | - Shuai Liu
- Department of Radiology, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, People's Republic of China
| | - Wenxiu Shu
- Department of Oncology and Hematology, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, People's Republic of China,
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15
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Metabolic Phase I (CYPs) and Phase II (GSTs) Gene Polymorphisms and Their Interaction with Environmental Factors in Nasopharyngeal Cancer from the Ethnic Population of Northeast India. Pathol Oncol Res 2017; 25:33-44. [PMID: 28952035 DOI: 10.1007/s12253-017-0309-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/13/2017] [Indexed: 01/06/2023]
Abstract
Multiple genetic and environmental factors and their interaction are believed to contribute in the pathogenesis of Nasopharyngeal Cancer (NPC). We investigate the role of Metabolic Phase I (CYPs) and Phase II (GSTs) gene polymorphisms, gene-gene and gene-environmental interaction in modulating the susceptibility to NPC in Northeast India. To determine the association of metabolic gene polymorphisms and environmental habits, 123 cases and 189 controls blood/swab samples were used for PCR and confirmed by Sanger sequencing. Analysis for GSTM1 and GSTT1 gene polymorphism was done by multiplex PCR. The T3801C in the 3'- flanking region of CYP1A1 gene was detected by PCR-RFLP method. The Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). The GSTM1 null genotype alone (OR = 2.76) was significantly associated with NPC risk (P < 0.0001). The combinations of GSTM1 null and GSTT1 null genotypes also higher, 3.77 fold (P < 0.0001), risk of NPC, while GSTM1 null genotype along with CYP1A1 T3801C TC + CC genotype had 3.22 (P = 0.001) fold risk. The most remarkable risk was seen among individual carrying GSTM1 null, GSTT1 null genotypes and CYP1A1 T3801C TC + CC genotypes (OR = 5.71, P = 0.001). Further; analyses demonstrate an enhanced risk of NPC in smoked meat (OR = 5.56, P < 0.0001) and fermented fish consumers (OR = 5.73, P < 0.0001) carrying GSTM1 null genotype. An elevated risk of NPC was noted in smokers (OR = 12.67, P < 0.0001) and chewers (OR = 5.68, P < 0.0001) with GSTM1 null genotype. However, smokers had the highest risk of NPC among individuals carrying GSTT1 null genotype (OR = 4.46, P = 0.001) or CYP1A1 T3801C TC + CC genotype (OR = 7.13, P < 0.0001). The association of null genotypes and mutations of metabolic neutralizing genes along with the environmental habits (tobacco smokers and chewers, smoke meat, fermented fishes) can be used as a possible biomarker for early detection and preventive measure of NPC.
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16
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Zhang L, MacIsaac KD, Zhou T, Huang PY, Xin C, Dobson JR, Yu K, Chiang DY, Fan Y, Pelletier M, Wang Y, Jaeger S, Krishnamurthy Radhakrishnan V, JeBailey L, Skewes-Cox P, Zhang J, Fang W, Huang Y, Zhao H, Zhao Y, Li E, Peng B, Huang A, Dranoff G, Hammerman PS, Engelman J, Bitter H, Zeng YX, Yao Y. Genomic Analysis of Nasopharyngeal Carcinoma Reveals TME-Based Subtypes. Mol Cancer Res 2017; 15:1722-1732. [DOI: 10.1158/1541-7786.mcr-17-0134] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/29/2017] [Accepted: 08/23/2017] [Indexed: 11/16/2022]
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17
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Carioli G, Negri E, Kawakita D, Garavello W, La Vecchia C, Malvezzi M. Global trends in nasopharyngeal cancer mortality since 1970 and predictions for 2020: Focus on low-risk areas. Int J Cancer 2017; 140:2256-2264. [DOI: 10.1002/ijc.30660] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/25/2017] [Accepted: 02/14/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Greta Carioli
- Department of Clinical Sciences and Community Health; Universitá degli Studi di Milano; Milan 20133 Italy
| | - Eva Negri
- Department of Epidemiology; IRCCS-Istituto di Ricerche Farmacologiche ‘Mario Negri’; Milan 20156 Italy
| | - Daisuke Kawakita
- Department of Otorhinolaryngology; Head and Neck Surgery, Nagoya City University, Graduate School of Medical Sciences; Nagoya Japan
- Division of Molecular Medicine; Aichi Cancer Center Research Institute; Nagoya Japan
| | - Werner Garavello
- Department of Otorhinolaryngology; School of Medicine and Surgery, University of Milano-Bicocca; Milan Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health; Universitá degli Studi di Milano; Milan 20133 Italy
| | - Matteo Malvezzi
- Department of Clinical Sciences and Community Health; Universitá degli Studi di Milano; Milan 20133 Italy
- Department of Epidemiology; IRCCS-Istituto di Ricerche Farmacologiche ‘Mario Negri’; Milan 20156 Italy
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18
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Baryshev VV, Andreev VG, Sevryukov FE, Buyakova ME, Akki ED. [Peculiarities of the early diagnostics of malignant nasopharyngal neoplasms]. Vestn Otorinolaringol 2017; 82:9-11. [PMID: 29072653 DOI: 10.17116/otorino20178259-11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The authors consider the risk factors and the specific clinical symptoms of the malignant nasopharyngal neoplasms as well as the methods for instrumental, laboratory, and pathomorphological diagnostics of this pathology. The full scale implementation of the recommendations for the timely detection of the tumours using the aforementioned diagnostic procedures and tests makes it possible to reduce to a minimum the interval between the establishment of the diagnosis and the onset of the relevant treatment at the early stages of the disease and thereby to ensure the improvement of its long-term outcomes.
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Affiliation(s)
- V V Baryshev
- A.F. Tsyb Medical Research Radiological Centre, Ministry of Health of the Russian Federation, Obninsk, Russia, 249036
| | - V G Andreev
- A.F. Tsyb Medical Research Radiological Centre, Ministry of Health of the Russian Federation, Obninsk, Russia, 249036
| | - F E Sevryukov
- A.F. Tsyb Medical Research Radiological Centre, Ministry of Health of the Russian Federation, Obninsk, Russia, 249036
| | - M E Buyakova
- A.F. Tsyb Medical Research Radiological Centre, Ministry of Health of the Russian Federation, Obninsk, Russia, 249036
| | - E D Akki
- A.F. Tsyb Medical Research Radiological Centre, Ministry of Health of the Russian Federation, Obninsk, Russia, 249036
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19
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Saikia A, Raphael V, Shunyu NB, Khonglah Y, Mishra J, Jitani AK, Medhi J. Analysis of Epstein Barr Virus Encoded RNA Expression in Nasopharyngeal Carcinoma in North-Eastern India: A Chromogenic in Situ Hybridization Based Study. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2016; 28:267-74. [PMID: 27602338 PMCID: PMC4994986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
INTRODUCTION Nasopharyngeal carcinoma (NPC) is a common cancer in the North-East region of India. Though the role of environmental contributors of NPC in the North-Eastern part of India is firmly established, EBV as an etiological agent in the region remains unexplored. MATERIAL AND METHODS Fifty-one patients, who presented at the department of ENT, NEIGRIHMS and were confirmed as NPC upon histopathological examination, were included in the study. Chromogenic in-situ hybridization (CISH) was used for the evaluation of EBER (Epstein Barr Virus Encoded RNA). Presence of nuclear signals was taken as positive for EBER expression. EBER status was correlated with various clinicopathological parameters like age, sex, dietary habits, histological types of NPC, and ethnicity of the patients. RESULTS The age range of the study group was 25 to 70 years with a mean age of 44.64 years and a male:female ratio of 3:2. Non-keratinizing undifferentiated type of NPC was the most common histological type. EBV was positive in 59% (30/51) of our cases. It showed a statistically significant correlation with the Naga community (P=0.01), with consumption of smoked food (P=0.02), and cigarette smoking (P=0.02). There was no correlation of EBV with age, sex, lymph node metastasis, stage, and histology. CONCLUSION Our result indicates that EBV may be an additional risk factor in the pathogenesis of NPC in this region of India. So apart from lifestyle modification, a future study for a screening test for EBV viral load even in asymptomatic patients may be considered, for determination of disease susceptibility, early diagnosis, and proper management.
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Affiliation(s)
- Anjan Saikia
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Vandana Raphael
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.,Corresponding Author: Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, Meghalaya, 793018 , India. Tel: +91 9436707442, E-mail:
| | - N-Brian Shunyu
- Department of Otorhinolaryngology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.
| | - Yookarin Khonglah
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.
| | - Jaya Mishra
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.
| | - Ankit-Kumar Jitani
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.
| | - Jayanta Medhi
- Department of Otorhinolaryngology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.
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20
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Conceiving a national head and neck cancer screening programme. The Journal of Laryngology & Otology 2015; 130:8-14. [PMID: 26585180 DOI: 10.1017/s0022215115003084] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study was undertaken to determine the optimum approach to screening for head and neck cancer based on international experiences. OBJECTIVE To determine whether or not head and neck cancer is suitable for screening, and, if so, what the ideal approach should be. METHODS An electronic search of online databases up to and including May 2014 was conducted. Key search terms included 'head and neck', 'cancer', 'screening', 'larynx', 'oropharynx' and 'oral'. RESULTS Subset analysis of high-risk cohorts showed statistically significant improvements in early detection of head and neck cancer via screening. CONCLUSION Current levels of public awareness regarding head and neck cancers are suboptimal, despite increased incidence and mortality. Scheduled and opportunistic screening, coupled with efforts to enhance education and health behaviour modification, are highly recommended for pre-defined, high-risk, targeted populations. This can enable early detection and therefore improve morbidity and mortality.
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21
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Lin JH, Jiang CQ, Ho SY, Zhang WS, Mai ZM, Xu L, Lo CM, Lam TH. Smoking and nasopharyngeal carcinoma mortality: a cohort study of 101,823 adults in Guangzhou, China. BMC Cancer 2015; 15:906. [PMID: 26573573 PMCID: PMC4647498 DOI: 10.1186/s12885-015-1902-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 11/03/2015] [Indexed: 11/30/2022] Open
Abstract
Background Nasopharyngeal carcinoma (NPC), also known as Cantonese cancer, is rare worldwide, but has particularly high incidence in North Africa and Southeast Asia, especially in Guangdong, China, such as Guangzhou. Tobacco causes head and neck cancers, but nasopharyngeal carcinoma is not included as causally related to smoking in the 2014 United States Surgeon General’s report. Prospective evidence remains limited. We used Guangzhou Occupational Cohort data to conduct the first and robust prospective study on smoking and NPC mortality in an NPC high-risk region. Methods Information on demographic characteristics and smoking status was collected through occupational health examinations in factories and driver examination stations from March 1988 to December 1992. Vital status and causes of deaths were retrieved until the end of 1999. Cox proportional hazard model was used to assess the association of smoking with NPC mortality. Results Of 101,823 subjects included for the present analysis, 34 NPC deaths occurred during the average 7.3 years of follow up. The mean age (standard deviation) of the subjects was 41 (5.7) years. Compared with never smokers, the hazard ratio (HR) of NPC mortality was 2.95 (95 % confidence interval 1.01–8.68; p = 0.048) for daily smokers and 4.03 (1.29–12.58; p = 0.016) for smokers with more than 10 pack-years of cumulative consumption, after adjusting for age, sex, education, drinking status, occupation and cohort status and accounting for smoking-drinking interaction. The risk of NPC mortality increased significantly with cigarettes per day (p for trend = 0.01) and number of pack-years (p for trend = 0.02). Conclusions In this first and largest cohort in a high NPC risk region, smoking was associated with higher NPC mortality. The findings have shown statistically significant dose–response trend between smoking amount and smoking cumulative consumption and the risk of NPC mortality, but due to the small event number, further studies with larger sample size are needed to confirm the findings in the present study. Our results support that smoking is one of the risk factors likely to be causally associated with NPC mortality. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1902-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jia-Huang Lin
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Chao-Qiang Jiang
- Guangzhou Occupational Diseases Prevention and Treatment Center, No 1 Tianqiang Street, Huang Pu Road West, Tianhe District, Guangzhou, 510620, China.
| | - Sai-Yin Ho
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Wei-Sen Zhang
- Guangzhou Occupational Diseases Prevention and Treatment Center, No 1 Tianqiang Street, Huang Pu Road West, Tianhe District, Guangzhou, 510620, China.
| | - Zhi-Ming Mai
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Lin Xu
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Ching-Man Lo
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Tai-Hing Lam
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
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Chong VH, Telisinghe PU, LIM E, Abdullah MS, Idris F, Chong CF. Declining Incidence of Nasopharyngeal Carcinoma in Brunei Darussalam: a Three Decade Study (1986-2014). Asian Pac J Cancer Prev 2015; 16:7097-101. [DOI: 10.7314/apjcp.2015.16.16.7097] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wei Y, Lin N, Zuo W, Luo H, Li Y, Liu S, Meng L, Fan A, Zhu L, Jacob TJC, Wang L, Chen L. Ethanol Promotes Cell Migration via Activation of Chloride Channels in Nasopharyngeal Carcinoma Cells. Alcohol Clin Exp Res 2015; 39:1341-51. [DOI: 10.1111/acer.12782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/14/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Yan Wei
- Department of Physiology ; Medical College; Jinan University; Guangzhou China
- Department of Pathophysiology; Medical College; Jinan University; Guangzhou China
| | - Na Lin
- Rongcheng Hospital; Rongcheng Shandong China
| | - Wanhong Zuo
- Department of Physiology ; Medical College; Jinan University; Guangzhou China
- Department of Pathophysiology; Medical College; Jinan University; Guangzhou China
| | - Hai Luo
- Department of Physiology ; Medical College; Jinan University; Guangzhou China
- Department of Pathophysiology; Medical College; Jinan University; Guangzhou China
| | - Yuan Li
- Department of Physiology ; Medical College; Jinan University; Guangzhou China
- Department of Pathophysiology; Medical College; Jinan University; Guangzhou China
| | - Shanwen Liu
- Department of Pathophysiology; Medical College; Jinan University; Guangzhou China
- Department of Pharmacology; Medical College; Jinan University; Guangzhou China
| | - Long Meng
- Department of Physiology ; Medical College; Jinan University; Guangzhou China
| | - Aihui Fan
- Department of Physiology ; Guangdong Medical College; Zhanjiang China
| | - Linyan Zhu
- Department of Pharmacology; Medical College; Jinan University; Guangzhou China
| | - Tim J. C. Jacob
- Cardiff School of Biosciences; Cardiff University; Cardiff United Kingdom
| | - Liwei Wang
- Department of Physiology ; Medical College; Jinan University; Guangzhou China
| | - Lixin Chen
- Department of Pharmacology; Medical College; Jinan University; Guangzhou China
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Nair J, Jain P, Chandola U, Palve V, Vardhan NRH, Reddy RB, Kekatpure VD, Suresh A, Kuriakose MA, Panda B. Gene and miRNA expression changes in squamous cell carcinoma of larynx and hypopharynx. Genes Cancer 2015; 6:328-40. [PMID: 26413216 PMCID: PMC4575920 DOI: 10.18632/genesandcancer.69] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/09/2015] [Indexed: 12/28/2022] Open
Abstract
Laryngo-pharyngeal squamous cell carcinomas are one of the most common head and neck cancers. Despite the presence of a large body of information, molecular biomarkers are not currently used in the diagnosis, treatment and management of patients for this group of cancer. Here, we have profiled expression of genes and microRNAs of larynx and hypopharynx tumors using high-throughput sequencing experiments. We found that matrix metalloproteinases along with SCEL, CRNN, KRT4, SPINK5, and TGM3 among others have significantly altered expression in these tumors. Alongside gene expression, the microRNAs hsa-miR-139, hsa-miR-203 and the hsa-miR-424/503 cluster have aberrant expression in these cancers. Using target genes for these microRNAs, we found the involvement of pathways linked to cell cycle, p53 signaling, and viral carcinogenesis significant (P-values 10(-13), 10(-9) and 10(-7) respectively). Finally, using an ensemble machine-learning tool, we discovered a unique 8-gene signature for this group of cancers that differentiates the group from the other tumor subsites of head and neck region. We investigated the role of promoter methylation in one of these genes, WIF1, and found no correlation between DNA methylation and down-regulation of WIF1. We validated our findings of gene expression, 8-gene signature and promoter methylation using q-PCR, data from TCGA and q-MSP respectively. Data presented in this manuscript has been submitted to the NCBI Geo database with the accession number GSE67994.
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Affiliation(s)
- Jayalakshmi Nair
- Ganit Labs, Bio-IT Centre, Institute of Bioinformatics and Applied Biotechnology, Biotech Park, Electronic City, Bangalore, India
| | - Prachi Jain
- Ganit Labs, Bio-IT Centre, Institute of Bioinformatics and Applied Biotechnology, Biotech Park, Electronic City, Bangalore, India
| | - Udita Chandola
- Ganit Labs, Bio-IT Centre, Institute of Bioinformatics and Applied Biotechnology, Biotech Park, Electronic City, Bangalore, India
| | - Vinayak Palve
- Ganit Labs, Bio-IT Centre, Institute of Bioinformatics and Applied Biotechnology, Biotech Park, Electronic City, Bangalore, India
| | - N R. Harsha Vardhan
- Mazumdar Shaw Centre for Translational Research, Mazumdar Shaw Medical Centre, Narayana Hrudayalaya, Bangalore, India
| | - Ram Bhupal Reddy
- Mazumdar Shaw Centre for Translational Research, Mazumdar Shaw Medical Centre, Narayana Hrudayalaya, Bangalore, India
| | - Vikram D. Kekatpure
- Mazumdar Shaw Centre for Translational Research, Mazumdar Shaw Medical Centre, Narayana Hrudayalaya, Bangalore, India
| | - Amritha Suresh
- Mazumdar Shaw Centre for Translational Research, Mazumdar Shaw Medical Centre, Narayana Hrudayalaya, Bangalore, India
| | - Moni Abraham Kuriakose
- Mazumdar Shaw Centre for Translational Research, Mazumdar Shaw Medical Centre, Narayana Hrudayalaya, Bangalore, India
| | - Binay Panda
- Ganit Labs, Bio-IT Centre, Institute of Bioinformatics and Applied Biotechnology, Biotech Park, Electronic City, Bangalore, India
- Strand Life Sciences, Bellary Road, Hebbal, Bangalore, India
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Zhang F, Zhu Z, Meadows GG, Zhang H. Chronic alcohol consumption inhibits melanoma growth but decreases the survival of mice immunized with tumor cell lysate and boosted with α-galactosylceramide. Int Immunopharmacol 2015; 28:359-68. [PMID: 26118634 DOI: 10.1016/j.intimp.2015.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/27/2015] [Accepted: 06/15/2015] [Indexed: 12/24/2022]
Abstract
Alcohol consumption increases the incidence of multiple types of cancer. However, how chronic alcohol consumption affects tumor progression and host survival remains largely unexplored. Using a mouse B16BL6 melanoma model, we studied the effects of chronic alcohol consumption on s.c. tumor growth, iNKT cell antitumor immune response, and host survival. The results indicate that although chronic alcohol consumption inhibits melanoma growth, this does not translate into increased host survival. Immunizing mice with a melanoma cell lysate does not significantly increase the median survival of water-drinking, melanoma-bearing mice, but significantly increases the median survival of alcohol-consuming, melanoma-bearing mice. Even though survival is extended in the alcohol-consuming mice after immunization, the median survival is not different from the immunized mice in the water-drinking group. Immunization with tumor cell lysate combined with α-galatosylceramide activation of iNKT cells significantly increases host survival of both groups of melanoma-bearing mice compared to their respective non-immunized counterparts; however, the median survival of the alcohol-consuming group is significantly lower than that of the water-drinking group. Alcohol consumption increases NKT cells in the thymus and blood and skews NKT cell cytokine profile from Th1 dominant to Th2 dominant in the tumor-bearing mice. In summary, these results indicate that chronic alcohol consumption activates the immune system, which leads to the inhibition of s.c. melanoma growth and enhances the immune response to immunization with melanoma lysate. With tumor progression, alcohol consumption accelerates iNKT cell dysfunction and compromises antitumor immunity, which leads to decreased survival of melanoma-bearing mice.
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Affiliation(s)
- Faya Zhang
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Spokane, WA 99210-1495, United States
| | - Zhaohui Zhu
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Spokane, WA 99210-1495, United States
| | - Gary G Meadows
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Spokane, WA 99210-1495, United States
| | - Hui Zhang
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Spokane, WA 99210-1495, United States.
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Ekpanyaskul C, Sangrajrang S, Ekburanawat W, Brennan P, Mannetje A, Thetkathuek A, Saejiw N, Ruangsuwan T, Boffetta P. Semi-Quantitative Exposure Assessment of Occupational Exposure to Wood Dust and Nasopharyngeal Cancer Risk. Asian Pac J Cancer Prev 2015; 16:4339-45. [DOI: 10.7314/apjcp.2015.16.10.4339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lakhanpal M, Singh LC, Rahman T, Sharma J, Singh MM, Kataki AC, Verma S, Chauhan PS, Singh YM, Wajid S, Kapur S, Saxena S. Contribution of susceptibility locus at HLA class I region and environmental factors to occurrence of nasopharyngeal cancer in Northeast India. Tumour Biol 2014; 36:3061-73. [PMID: 25514873 DOI: 10.1007/s13277-014-2942-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/04/2014] [Indexed: 12/21/2022] Open
Abstract
High incidence of nasopharyngeal carcinoma (NPC) has been reported from China, Southeast Asia and Northeast (NE) region of India. Populations at geographic regions having higher incidence of NPC display human leukocyte antigen (HLA) distribution patterns different from areas having low incidence. The current study has investigated the contribution of environmental risk factors and ethnic variation of microsatellite markers in HLA region for the high incidence of NPC in NE India. Genotyping of HLA region using 33 microsatellite markers by fragment length analysis was done in 220 study subjects (120 NPC patients and 100 healthy controls). Association analysis showed two adjacent microsatellite markers HL003 (allele 121) and D6S2704 (allele 218) in the HLA class I region having association with high risk of NPC while allele 127 of HL003 and allele 255 of D6S2678 conferred a protective effect. The environmental factors mainly use of firewood (odds ratio (OR) = 3.797385, confidence interval (CI) = 1.97-7.30, P < 0), living in mud house (OR = 3.46, CI = 1.19-10.08, P = 0.022) and consumption of alcohol (OR = 2.11, CI = 1.02-4.37, P = 0.043) were found as major risk factors for NPC. Higher-order interaction showed combination of smoked food consumption and firewood use for cooking in multifactor dimensionality reduction (MDR) analysis and interaction of non-firewood users, non-ventilated houses and residence in mud houses in classification and regression tree (CART) analysis as the significant risk factors for NPC. Expression of Epstein-Barr virus (EBV) RNA was found in 92% (23/25) of NPC cases suggesting its significant role in NPC aetiopathogenesis. This study identified association of NPC with a susceptibility locus in the HLA class I region which has complex interaction with viral DNA and environmental factors.
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Affiliation(s)
- Meena Lakhanpal
- Safdarjang Hospital Campus, Indian Council of Medical Research, National Institute of Pathology, New Delhi, 110029, India
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Roberts DO, Nickel KB, Mattfeldt-Beman M, Fearn N, Jones L, Cottler LB. Drinking severity and its association with nutrition risk among African American women. J Ethn Subst Abuse 2014; 13:93-103. [PMID: 24853360 DOI: 10.1080/15332640.2013.847395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This analysis examined the association between drinking severity, food insecurity, and drinking related health comorbidities among 258 African American women who drank heavily from the "Sister to Sister" study. Women were stratified by drinking status: 23% were heavy drinkers (women who drank 30 to 52 weeks in the 12 months prior to study participation and consumed the equivalent of at least 20 alcoholic beverages at one sitting) and 77% were less heavy drinkers (women with all other combinations of drinking habits who drank less than 30 weeks in the 12 months prior to study participation). Heavy drinkers were more likely to not check nutrition labels, skip meals to buy drugs/alcohol, and report a history of stomach disease, diabetes, memory, weight, and kidney problems compared with less heavy drinkers. The heavy drinkers were at increased nutrition risk due to food insecurities and were more susceptible to drinking related health comorbidities compared with less heavy drinkers.
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Hung SH, Chen PY, Lin HC, Ting J, Chung SD. Association of rhinosinusitis with nasopharyngeal carcinoma: a population-based study. Laryngoscope 2014; 124:1515-20. [PMID: 24114992 DOI: 10.1002/lary.24435] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 08/28/2013] [Accepted: 09/13/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS Although it is already known that the inflammation process elevates the risk of developing cancer, to date the association between rhinosinusitis and nasopharyngeal carcinoma (NPC) remains unknown. This study aimed to evaluate the association between rhinosinusitis and NPC based on a nationwide database. STUDY DESIGN Case-control study. METHODS In total, the cases comprised of 2,242 subjects with NPC and 6,726 randomly selected subjects as controls. Separate conditional logistic regression analyses were used to calculate the odds ratio (OR) for having been previously diagnosed with chronic and acute rhinosinusitis between the cases and controls. RESULTS Of the total sample, 607 subjects (6.77%) had been diagnosed with chronic rhinosinusitis prior to the index date: 322 (14.36%) cases with NPC and 285 (4.24%) controls (P<.001). A conditional logistic regression analysis revealed that the OR of prior chronic rhinosinusitis for subjects with NPC is 3.83 (95% confidence interval [CI], 3.23-4.53) as compared to controls after adjusting for the factors of income, urbanization, geographic location, tobacco use disorder, and alcohol abuse/dependence syndrome. Furthermore, 1,199 (53.48%) cases and 2,938 (42.19%) controls had been diagnosed with acute rhinosinusitis prior to the index date (P<.001).The adjusted OR of prior acute rhinosinusitis for subjects with NPC was 1.57 (95% CI, 1.43-1.73) that of controls. CONCLUSIONS This study detected an association between NPC and rhinosinusitis. We recommend that patients who are diagnosed with rhinosinusitis, either acute or chronic, seek out aggressive management to reduce the tissue burden and lower the risk of subsequently developing NPC. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
- Shih-Han Hung
- Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan
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Yan Z, Xia L, Huang Y, Chen P, Jiang L, Zhang B. Nasopharyngeal carcinoma in children and adolescents in an endemic area: a report of 185 cases. Int J Pediatr Otorhinolaryngol 2013; 77:1454-60. [PMID: 23830224 DOI: 10.1016/j.ijporl.2013.06.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 06/02/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND This study aimed to demonstrate the clinical and therapeutic features of nasopharyngeal carcinoma (NPC) in children and adolescents in Southern China, an endemic area. PATIENTS AND METHODS A total of 185 newly diagnosed NPC patients younger than 21 years old in the Sun Yat-sen University Cancer Center from 1993 to 2011 were retrospectively analyzed. Overall survival (OS) rate estimates and Kaplan-Meier survival curves were calculated. Cox proportional hazard ratios (HRs) were used to identify independent prognostic factors for survival. Chi-square test was used to compare the incidence of sequelae and the stage distribution between different subgroups. RESULTS Most patients were male (71.4%). The main presenting symptoms were neck mass (44.9%), tinnitus/hearing loss (36.2%), bloody nasal discharge (22.7%), headache (22.2%), and nasal obstruction (20.0%). Stage I, II, III, and IV patients accounted for 1.1%, 8.1%, 43.8%, and 47.0%, respectively, of the total number of patients included in the study. All patients were treated by radiotherapy: 39 Gy-84 Gy to primary tumors (median, 68 Gy) and 36 Gy-74 Gy to cervical lymph nodes (median, 60 Gy); 84.3% of the patients were treated by chemotherapy either. The complete response rate was 94.1%. The 5-, 10-, and 15-year survival rates were 78% ± 4%, 70% ± 5%, and 66% ± 6%, respectively. Tumor node metastasis (TNM) stage was the statistically significant predictor of distal metastasis and OS. Distal metastasis was the major pattern of treatment failure. The main long-term complications of therapy were xerostomia (47.0%), hearing loss (28.1%), neck fibrosis (24.3%), trismus (12.4%), glossolalia (7.0%), and radiation encephalopathy (5.4%). The incidences of these morbidities were significantly higher in the high radiation dose (more than the median) group than in the low radiation dose group (less than or equal to the median), while no differences in survival were observed. CONCLUSIONS In spite of the majority of patients diagnosed at the advanced stage, children and adolescents with NPC had excellent survival except metastatic disease. The TNM stage was the most relevant prognostic factor. A higher radiation dose (>68 Gy) could not improve survival but could increase long-term morbidities.
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Affiliation(s)
- Zheng Yan
- VIP Region, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, China
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Xue WQ, Qin HD, Ruan HL, Shugart YY, Jia WH. Quantitative association of tobacco smoking with the risk of nasopharyngeal carcinoma: a comprehensive meta-analysis of studies conducted between 1979 and 2011. Am J Epidemiol 2013; 178:325-38. [PMID: 23785114 DOI: 10.1093/aje/kws479] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Over the years, many studies have attempted to establish a link between tobacco smoking and an increased risk of nasopharyngeal carcinoma (NPC), but their results have been inconsistent. To clarify this link, we first conducted a comprehensive meta-analysis to integrate the findings of epidemiologic studies from the last half-century. The methodology used for this study followed the checklist proposed by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) Group. Pooled risk estimates were generated using a random-effects model. Twenty-eight case-control studies and 4 cohort studies involving a total of 10,274 NPC cases and 415,266 comparison subjects were included. A substantial effect of smoking on the risk of NPC was identified in this study. The results showed that ever smokers had a 60% greater risk of developing the disease than never smokers (95% confidence interval: 1.38, 1.87); this was a robust dose-dependent association. More importantly, stronger associations were observed in low-risk populations and among persons with the predominant histological type of differentiated NPC than in high-risk populations and persons with an undifferentiated type; the odds ratios were 1.76 and 2.20, respectively, versus 1.29 and 1.27. In this comprehensive meta-analysis, well-established statistical evidence was provided about the role of tobacco smoking in the etiology of NPC.
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Affiliation(s)
- Wen-Qiong Xue
- State Key Laboratory of Oncology in Southern China, Department of Experimental Research, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People’s Republic of China
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Sheng L, Sun X, Zhang L, Su D. ABO blood group and nasopharyngeal carcinoma risk in a population of Southeast China. Int J Cancer 2013; 133:893-7. [PMID: 23389798 DOI: 10.1002/ijc.28087] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 01/21/2013] [Indexed: 12/29/2022]
Abstract
Previous studies found that the ABO blood type alters the individual susceptibility of some malignancies. However, whether such an association exists between ABO blood type and nasopharyngeal carcinoma (NPC) remains unknown. A case-control study was conducted, with 1,538 patients who had NPC and 1,260 cancer-free controls. The association between ABO blood type and NPC incidence was evaluated using unconditional logistic regression analysis. Compared with subjects with blood type O, a relatively higher risk was observed among cases with blood types A or AB, with ORs (95% confidence interval) of 1.287 (1.072 - 1.545), p = 0.007 and 1.390 (1.007 - 1.919), p = 0.045, respectively, after adjusting for gender, age, smoking status and family history of cancer. The rate of distant metastasis was significantly higher among male patients with blood type A than in patients with non-A blood types (6.8 vs. 3.5%, p = 0.027). Our results suggest that blood types A or AB is associated with an increased risk of NPC. Further studies are needed to confirm this association and to explore the mechanisms involved.
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Affiliation(s)
- Liming Sheng
- Department of Radiation Therapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
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Feng BJ. Descriptive, Environmental and Genetic Epidemiology of Nasopharyngeal Carcinoma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013. [DOI: 10.1007/978-1-4614-5947-7_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hutajulu SH, Ng N, Jati BR, Fachiroh J, Herdini C, Hariwiyanto B, Haryana SM, Middeldorp JM. Seroreactivity against Epstein-Barr virus (EBV) among first-degree relatives of sporadic EBV-associated nasopharyngeal carcinoma in Indonesia. J Med Virol 2012; 84:768-76. [PMID: 22431025 DOI: 10.1002/jmv.23263] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Epstein-Barr virus (EBV) infection and family history are significant risk factors associated with undifferentiated nasopharyngeal carcinoma. The presence of aberrant immunoglobulin A (IgA) antibodies against specific EBV antigens in healthy individuals can be predictive of the disease. Very limited reports explored the EBV IgA antibody presence within families of sporadic cases of nasopharyngeal carcinoma. This study aimed to determine whether EBV IgA was observed more frequently among family members of sporadic cases of nasopharyngeal carcinoma compared to community controls and evaluated the non-viral factors as determinants of antibody level. First-degree relatives of nasopharyngeal carcinoma patients (n = 520) and case-matched community controls (n = 86) were recruited. Sera from all individuals were tested in standardized peptide-based EBV IgA ELISA. Data on demographic variables and other exogenous factors were collected using a questionnaire through face-to-face interviews. A similar frequency of EBV IgA (cut-off value/CoV 0.354) was observed in the first-degree relatives of cases and in community controls (41.2% vs. 39.5%, P = 0.770). However, with a higher antibody level (OD(450) = 1.000; about three times standard CoV), the relatives showed significantly higher frequency (36.9% vs. 14.7%, P = 0.011). When adjusted for all exogenous factors, the strongest factors associated with seropositivity are being a father (odds ratio/OR = 4.36; 95% confidence interval/CI = 1.56-12.21) or a sibling (OR = 1.89; 95% CI = 1.06-3.38) of a case of nasopharyngeal carcinoma. The higher level of EBV IgA seroreactivity in first-degree relatives of sporadic cases of nasopharyngeal carcinoma compared to the general population supports the use of EBV IgA ELISA for screening among family members.
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Affiliation(s)
- Susanna Hilda Hutajulu
- Department of Internal Medicine, Faculty of Medicine/Dr. Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Davey S, Baer S. A rare case of breast cancer metastasising to the nasopharynx and paranasal sinuses. Int J Surg Case Rep 2012; 3:460-2. [PMID: 22743009 DOI: 10.1016/j.ijscr.2012.05.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 05/13/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Metastatic spread from non-head and neck tumours to the sinonasal region is exceedingly rare. We present a case of breast cancer metastasis to the nasopharynx, ethmoid and sphenoid sinuses. To date there have been only two similar cases in the literature. We discuss the diagnosis and management of such cases and propose how they may be staged. PRESENTATION OF CASE A 75-year-old woman with past medical history of breast carcinoma, presented clinically as having a primary sinonasal malignancy. Magnetic resonance imaging (MRI) demonstrated a lesion involving the spenoid and ethmoid sinuses, nasendoscopy revealed a mass in the nasopharynx. Biopsy from clinic pointed to inverted sinonasal papilloma, however this did not fit with the MRI or the clinical picture. Repeat biopsy under image guidance revealed the lesion to be a breast cancer metastasis. DISCUSSION An extensive literature review revealed few cases of spread to the sinonasal region from distant primary malignancy. When such cases do arise, most are from renal tumours. Breast cancer metastases usually present with signs and symptoms of disseminated disease, however our case represents a true isolated metastasis. We discuss the management of our case and suggest the use of the tumour-node-metastasis (TNM) system, in order to stage these rare isolated occurrences. CONCLUSION If discovered early, this rare manifestation may be managed by primary surgical resection. Metastases to the region may be more common than previously thought. A high index of suspicion should be employed, especially where there is past medical history of malignancy.
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Affiliation(s)
- Shaun Davey
- Department of Otolaryngology, Head & Neck Surgery, Royal Sussex County Hospital (Brighton and Sussex University Hospitals NHS Trust), Eastern Road, Brighton BN2 5BE, United Kingdom
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Non-viral environmental risk factors for nasopharyngeal carcinoma: a systematic review. Semin Cancer Biol 2012; 22:117-26. [PMID: 22311401 DOI: 10.1016/j.semcancer.2012.01.009] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 01/19/2012] [Accepted: 01/20/2012] [Indexed: 11/20/2022]
Abstract
This review aims to systematically summarize the epidemiological studies on nasopharyngeal carcinoma (NPC) conducted over the past half century, covering descriptive epidemiological studies and reports on non-viral risk factors. Multiple lines of epidemiologic evidence for established risk factors are systematically presented in comprehensive tables. The potential interactions among environmental factors and genetic components, and also the impacts of parallel sequencing technology on the aetiology of NPC are discussed. Finally, we propose a modified model for the pathogenesis of nasopharyngeal carcinoma based on the current knowledge.
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Mesmoudi M, Mahfoud T, Ismaili N, Rami K, Kamouni M, Jroundi L, Errihani H. A Synchronous undifferentiated nasopharyngeal carcinoma and infiltrating ductal carcinoma of the breast successfully treated with induction chemotherapy followed by local control of both tumours: a case report. BMC EAR, NOSE, AND THROAT DISORDERS 2011; 11:6. [PMID: 21658269 PMCID: PMC3127834 DOI: 10.1186/1472-6815-11-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 06/09/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Multiple primary cancers have a low incidence particularly when cancers are synchronous. Few cases of synchronous head and neck cancer and breast carcinoma are reported in the literature. CASE PRESENTATION We report here an exceptional case of a 47 years old Moroccan woman presenting two synchronous cancers, the first in the nasopharynx and the second in the breast. The patient was treated successfully with a combined strategy associating chemotherapy, radiation therapy, and surgery. She remains disease free after 27 months of follow up. CONCLUSIONS Treatment strategy in the case of multiple primary cancers remains controversial because of the variety of presentations; initial aggressive treatment reports good results.
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Affiliation(s)
- Mohamed Mesmoudi
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco.
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Polesel J, Franceschi S, Talamini R, Negri E, Barzan L, Montella M, Libra M, Vaccher E, Franchin G, La Vecchia C, Serraino D. Tobacco smoking, alcohol drinking, and the risk of different histological types of nasopharyngeal cancer in a low-risk population. Oral Oncol 2011; 47:541-5. [PMID: 21478046 DOI: 10.1016/j.oraloncology.2011.03.017] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 03/11/2011] [Accepted: 03/14/2011] [Indexed: 12/22/2022]
Abstract
Nasopharyngeal carcinoma (NPC) is rare in western Countries. Tobacco smoking is a well-recognised risk factor, whereas the role of alcohol drinking is still in debate. We conducted a hospital-based case-control study in Italy on 150, histologically-confirmed, NPC cases of Caucasian ethnicity, aged 18-76years, including 118 undifferentiated NPCs and 22 differentiated squamous-cell NPC. Controls were 450 Caucasian cancer-free patients admitted to general hospitals for acute conditions. Cases and controls were matched according to sex, age, and place of residence. Logistic regression was used to estimate odds ratios (OR) and the corresponding 95% confidence intervals (CI) while adjusting for known confounders. No significant association emerged between tobacco smoking and all NPCs (OR for current vs. never smokers=1.52; 95% CI: 0.89-2.60). Conversely, for differentiated NPC only, statistically significant elevated OR were associated with increasing smoking intensity (OR for ⩾15cigarettes/day=5.40; 95% CI: 1.34-21.76) and duration of the habit (OR for ⩾32years=4.48; 95% CI: 1.11-18.04). Although alcohol drinking was not, per se, significantly associated to NPC risk, the combination of tobacco smoking and alcohol drinking accounted for 57% of differentiated NPCs, whereas it accounted for only 14% of undifferentiated carcinomas. Our findings suggest that, in western populations, NPC includes two separate entities: the differentiated NPC, associated with tobacco smoking like other cancers of head and neck, and the undifferentiated NPC, upon which tobacco smoking has little or no influence.
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Affiliation(s)
- Jerry Polesel
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Via F. Gallini 2, 33081 Aviano (PN), Italy.
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Matalka I, Al Hamad M, Al-Hussaini M, Alzoubi FQ. The incidence of Epstein-Barr virus in nasopharyngeal carcinoma of Jordanian patients. Eur Arch Otorhinolaryngol 2011; 269:229-34. [PMID: 21409390 DOI: 10.1007/s00405-011-1562-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 03/03/2011] [Indexed: 10/18/2022]
Abstract
Aim of this study was to investigate the incidence of Epstein-Barr virus (EBV) in patients diagnosed with undifferentiated nasopharyngeal carcinoma (UNPC) from the Northern Province of Jordan. All cases diagnosed with UNPC at King Abdullah University Hospital, Irbid, Jordan, between the years 1991 and 2009 inclusive were examined. Clinical data including age, gender, mode of presentation, site of biopsy were retrieved from pathology reports. In situ hybridization for (EBV)--EBERs was performed on cases with available paraffin blocks. Correlation between the different clinical variables and results of in situ hybridization was performed. There were 49 cases diagnosed with UNPC, only 39 specimens were available and studied. The median age of presentation was 41 years (range 9-70 years). Bimodal age distribution was noted, the first peak between 15 and 19 years of age and second between 60 and 64 years of age. Males were slightly more commonly affected than females. Cervical lymph node enlargement was the most common mode of presentation, followed by nasal obstruction. Biopsies were obtained primarily from the posterior nasal space, followed by cervical lymph node. Positive staining for EBERs by in situ hybridization was seen in 92.3% of the cases examined. There was no difference in detection rate between males and females or adults and pediatrics. All cases obtained from posterior nasal space were positive. The three negative cases were from biopsies obtained from cervical lymph nodes, which was statistically significant (P value <0.05). Nasopharyngeal carcinoma in Jordan is seen in both children and adults. It is associated with EBV infection in most, but not all cases. Posterior nasal space shows a more consistent staining for EBERs than cervical lymph nodes. The presence of other association with UNPC including cigarette smoking could possibly explain the cases with negative association.
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Affiliation(s)
- Ismail Matalka
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan
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Explaining the effects of socio-economic deprivation on survival in a national prospective cohort study of 1909 patients with head and neck cancers. Cancer Epidemiol 2010; 34:682-8. [DOI: 10.1016/j.canep.2010.05.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 05/13/2010] [Accepted: 05/15/2010] [Indexed: 11/21/2022]
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Padilla H, Michael Gaziano J, Djoussé L. Alcohol consumption and risk of heart failure: a meta-analysis. PHYSICIAN SPORTSMED 2010; 38:84-9. [PMID: 20959700 DOI: 10.3810/psm.2010.10.1812] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Heart failure is highly prevalent among older adults and is associated with high treatment costs. Identifying modifiable determinants of heart failure may help in prevention. Alcohol consumption has emerged as a modifiable risk factor for cardiovascular diseases. Although many studies have suggested a positive association between heavy drinking and cardiomyopathy, the association between infrequent or light-to-moderate drinking and heart failure risk has been less conclusive. PURPOSE To examine the relation between various levels of alcohol intake and incident heart failure. METHODS We conducted a meta-analysis of 6 studies obtained through a PubMed literature search. Alcohol drinkers were classified as never, former, and current drinkers of 0.1 to 0.9, 1 to 7, 8 to 14, and > 14 drinks per week. RESULTS Compared with never drinkers, the pooled relative risks were 1.16 (95% confidence interval [CI], 0.90-1.51) for former drinkers, 0.90 (95% CI, 0.83-0.98), 0.80 (95% CI, 0.73-0.88), 0.78 (95% CI, 0.65-0.95), and 0.77 (95% CI, 0.63-0.95) for current drinkers of 0.1 to 0.9, 1 to 7, 8 to 14, and > 14 drinks per week, respectively, in a random effects model. CONCLUSION These data suggest that infrequent and light-to-moderate drinking is associated with a lower risk of heart failure.
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Affiliation(s)
- Heather Padilla
- Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02120, USA.
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Risk factors for the occurrence of undifferentiated carcinoma of nasopharyngeal type: A case-control study. SRP ARK CELOK LEK 2010; 138:6-10. [DOI: 10.2298/sarh1002006n] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction. The incidence rate of nasopharyngeal carcinoma in Serbia is less than one per 100,000 citizens, which classifies it as a region with low incidence for this disease. Objective. The aim of this study was to test some hypotheses of the risk factors for undifferentiated carcinoma of nasopharyngeal type (UCNT) in the low incidence population. Methods. A case-control study was used for the research. The study included 45 cases with histopathological diagnosis of UCNT and 90 controls. Cases and the controls were individually matched by sex, age (?3 years), and place of residence (city-village). Data were gathered about sociodemographic characteristics, occupational exposure to harmful agents, habits, diet, personal history, and family history. In the analysis of the data, conditional univariate and multivariate logistic regression analyses were applied. Results. According to the results of multivariate logistic regression analysis UCNT was significantly positively associated with 'passive smoking' of tobacco in the family during childhood, frequent consumption of industrially manufactured food additives for enhancing flavour and frequent consumption of white bread. UCNT was significantly negatively associated with frequent consumption of margarine, olive oil and cornbread. Conclusion. In our low incidence population, an independent risk factor for the occurrence of UCNT was 'passive smoking' of tobacco in the family during childhood, use of industrially manufactured food with additives for enhancing flavour and consumption of white bread. Multicentric study enrolling a greater number of cases would be desirable.
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