Plaza G, Fogué L, Martínez San Millán J, Martínez Vidal A, Bellas C
Unidad de Otorrinolaringología, Fundación Hospital Alcorcón.
An Otorrinolaringol Ibero Am. 2002;29(1):71-91.
We present a retrospective series of 27 nasopharyngeal carcinomas, selected from those attended at Ramón y Cajal Hospital between 1977 and 1996, with the aim of review the role of the study of Epstein-Barr virus in the diagnostic process of nasopharyngeal carcinoma. Twenty-seven patients, ranging from 14 to 81 years, with an average age of 50 years were selected. Male/female ratio was 1,7. All but one case were Caucasian. A neck mass was the first symptom in 40% of cases, with a mean diagnostic delay of 17 months. Only 8 cases (23%) did not exhibit neck nodes at the moment of diagnosis. CT and MRI were essential to establish staging: 5 stage I, 7 stage II and 15 stage IV, due to regional extension and/or bone erosion. Radiotherapy was employed in all cases, helped by chemotherapy in 20% of them. With a mean follow-up of 62 months, 5-years survival was 32% (IC 14,06-52,09). Of 27 cases of nasopharyngeal carcinoma 4 were differentiated (type I), 2 moderately differentiated (type II) and 22 undifferentiated (type III). While LMP-1 was only expressed by 41% of cases, PCR detected Epstein-Barr virus genome in 26 cases (96%) and in situ hybridization for EBERs was positive in all cases. Thus, all nasopharyngeal carcinomas were related to Epstein-Barr virus. Expression of LMP-1 seemed to worse the prognosis of nasopharyngeal carcinoma.
我们回顾性分析了1977年至1996年间在拉蒙·卡哈尔医院就诊的27例鼻咽癌病例，旨在探讨爱泼斯坦-巴尔病毒研究在鼻咽癌诊断过程中的作用。选取了27例患者，年龄在14岁至81岁之间，平均年龄为50岁。男女比例为1.7。除1例病例外，所有病例均为白种人。40%的病例首发症状为颈部肿块，平均诊断延迟17个月。仅8例（23%）在诊断时未出现颈部淋巴结。CT和MRI对于确定分期至关重要：5例为I期，7例为II期，15例为IV期，原因是局部扩散和/或骨质侵蚀。所有病例均采用了放疗，其中20%的病例辅助化疗。平均随访62个月，5年生存率为32%（可信区间14.06 - 52.09）。27例鼻咽癌中，4例为高分化（I型），2例为中分化（II型），22例为低分化（III型）。虽然只有41%的病例表达LMP - 1，但PCR检测发现26例（96%）有爱泼斯坦-巴尔病毒基因组，EBERs原位杂交在所有病例中均为阳性。因此，所有鼻咽癌均与爱泼斯坦-巴尔病毒有关。LMP - 1的表达似乎会使鼻咽癌的预后更差。
