A prospective evaluation of patients with nasopharyngeal carcinoma: an overview.

One hundred and eighty-two patients in North America with nasopharyngeal carcinoma underwent initial and interval estimations of serum viral capsid antigen (VCA) and early antigen (EA), and the sera were also titrated for antibody to the Epstein-Barr virus induced membrane antigen complex by using the antibody-dependent cellular cytotoxicity (ADCC) assay. The serologic findings differentiated the World Health Organization (WHO) type 1 tumors (keratinizing squamous cell carcinomas) from the WHO types 2 and 3 tumors (nonkeratinizing and undifferentiated carcinomas) which were often small, submucosal and hard to detect. Prospective evaluation of the predictive value of staging variables has shown that the extent of tumor within the nasopharynx, involvement of lower neck nodes, WHO tumor type, ADCC titer, the number of symptoms and the patient's age are the most important.