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鼻咽癌的研究现状。

Current Perspectives on Nasopharyngeal Carcinoma.

机构信息

Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia.

Division of Genomics of Development and Disease, Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia.

出版信息

Adv Exp Med Biol. 2019;1164:11-34. doi: 10.1007/978-3-030-22254-3_2.

Abstract

Of the ~129,079 new cases of nasopharyngeal carcinoma (NPC) and 72,987 associated deaths estimated for 2018, the majority will be geographically localized to South East Asia, and likely to show an upward trend annually. It is thought that disparities in dietary habits, lifestyle, and exposures to harmful environmental factors are likely the root cause of NPC incidence rates to differ geographically. Genetic differences due to ethnicity and the Epstein Barr virus (EBV) are likely contributing factors. Pertinently, NPC is associated with poor prognosis which is largely attributed to lack of awareness of the salient symptoms of NPC. These include nose hemorrhage and headaches and coupled with detection and the limited therapeutic options. Treatment options include radiotherapy or chemotherapy or combination of both. Surgical excision is generally the last option considered for advanced and metastatic disease, given the close proximity of nasopharynx to brain stem cell area, major blood vessels, and nerves. To improve outcome of NPC patients, novel cellular and in vivo systems are needed to allow an understanding of the underling molecular events causal for NPC pathogenesis and for identifying novel therapeutic targets and effective therapies. While challenges and gaps in current NPC research are noted, some advances in targeted therapies and immunotherapies targeting EBV NPCs are discussed in this chapter, which may offer improvements in outcome of NPC patients.

摘要

在 2018 年估计的 129079 例新的鼻咽癌(NPC)病例和 72987 例相关死亡病例中,大多数病例将在地理位置上局限于东南亚,并可能每年呈上升趋势。人们认为,饮食习惯、生活方式和接触有害环境因素的差异可能是 NPC 发病率存在地域差异的根本原因。由于种族和 Epstein-Barr 病毒(EBV)的遗传差异可能也是促成因素。值得注意的是,NPC 预后不良,这在很大程度上归因于人们对 NPC 明显症状缺乏认识。这些症状包括鼻出血和头痛,再加上检测和有限的治疗选择。治疗选择包括放疗或化疗或两者的联合治疗。由于鼻咽与脑干区域、主要血管和神经的位置接近,手术切除通常是晚期和转移性疾病的最后选择。为了改善 NPC 患者的预后,需要新型的细胞和体内系统来了解导致 NPC 发病机制的潜在分子事件,并确定新的治疗靶点和有效的治疗方法。尽管注意到目前 NPC 研究中的挑战和差距,但本章讨论了针对 EBV NPC 的靶向治疗和免疫治疗的一些进展,这可能会改善 NPC 患者的预后。

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