Macdonald M R, Freeman J L, Hui M F, Cheung R K, Warde P, McIvor N P, Irish J, Dosch H M
Department of Otolaryngology, Hospital for Sick Children, Toronto, Canada.
Head Neck. 1995 Nov-Dec;17(6):487-93. doi: 10.1002/hed.2880170606.
The patient with nasopharyngeal carcinoma (NPC) frequently is initially seen with regional node dissemination. Preliminary investigations suggest that the presence of Epstein-Barr virus (EBV) genomes in neck metastases from an occult primary may be diagnostic and predictive of NPC. The goal of this study was to test this proposition.
The polymerase chain reaction (PCR) was used to detect the presence of EBV DNA in fine-needle aspirate (FNA) samples obtained from malignant neck nodes. Control samples were obtained from other locations in the head and neck.
The patients in this study were evaluated at the Toronto Princess Margaret Hospital, a province-wide tertiary-care cancer treatment center. Of the 23 patients evaluated with malignant neck masses, 6 had NPC, 5 patients had metastatic squamous cell carcinoma of an unknown primary, and 12 patients served as controls with other known head and neck carcinomas. One of the patients initially diagnosed as an unknown primary later demonstrated NPC. FNA specimens were also obtained from 24 normal parotid, submandibular, or thyroid glands for comparison.
In the samples with sufficient DNA for analysis, EBV was detected in 5 of 5 neck nodes from patients with known NPC. EBV was also detected in the neck node of a patient who went on to develop NPC and in a cervical node from 1 of 2 patients in whom the primary tumor remained unknown. None of the evaluable control neck nodes of FNA controls from other sites demonstrated EBV.
These results demonstrate the utility of NPC-diagnostic EBV gene amplification in FNA samples of neck metastases and suggest that the presence of the EBV genome in FNA samples of neck nodes is predictive of the presence of NPC.
鼻咽癌（NPC）患者初诊时常常已有区域淋巴结转移。初步研究表明，隐匿性原发灶颈部转移灶中存在爱泼斯坦 - 巴尔病毒（EBV）基因组可能对鼻咽癌具有诊断和预测价值。本研究的目的是验证这一观点。
采用聚合酶链反应（PCR）检测从恶性颈部淋巴结获取的细针穿刺抽吸（FNA）样本中EBV DNA的存在情况。对照样本取自头颈部的其他部位。
本研究中的患者在安大略省三级癌症治疗中心多伦多公主玛格丽特医院接受评估。在评估的23例有恶性颈部肿块的患者中，6例患有鼻咽癌，5例患有原发灶不明的转移性鳞状细胞癌，12例作为其他已知头颈部癌的对照。最初诊断为原发灶不明的1例患者后来确诊为鼻咽癌。还从24个正常腮腺、颌下腺或甲状腺获取FNA标本用于比较。
在有足够DNA用于分析的样本中，已知患有鼻咽癌患者的5个颈部淋巴结中有5个检测到EBV。在后来发展为鼻咽癌的1例患者的颈部淋巴结以及2例原发肿瘤仍不明的患者中的1例的颈部淋巴结中也检测到EBV。来自其他部位的FNA对照的可评估对照颈部淋巴结均未检测到EBV。
这些结果证明了在颈部转移灶的FNA样本中进行鼻咽癌诊断性EBV基因扩增的实用性，并表明颈部淋巴结FNA样本中EBV基因组的存在可预测鼻咽癌的存在。
