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3.
Br J Radiol ; 92(1102): 20190068, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31150279

RESUMO

Nasopharyngeal cancer (NPC) is notable for its wide geographic variation, with incidences as high as 30 in 100,000 in endemic regions but < 1 in 100,000 worldwide. This review aims to identify areas where there could be differences in prognosis, management or outcomes among countries with high or low incidence of NPC. The incidence has generally declined both in endemic and non-endemic regions throughout the years, which may be attributed to the decrease in exposure to risk factors such as early exposure to salted fish and smoking. Ethnicity has an impact both on incidence and prognosis, with Southeast Asians having the highest incidence but also better survival. Concurrent chemoradiotherapy, with or without adjuvant and/or induction chemotherapy, is the standard of care for locoregionally advanced disease, as reflected in clinical practice guidelines. Despite improvements in management, a proportion of patients relapse. Salvage treatment is associated with significant morbidity due to the critical location of the nasopharynx and the toxicities of initial therapy. Clinical expertise is paramount, but is easier to attain in endemic regions and high volume centers where enrollment of patients in clinical trials is more feasible. Collaboration between low and high incidence countries and between low and high volume facilities is key to improving NPC prognosis worldwide.


Assuntos
Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/terapia , Biomarcadores Tumorais/sangue , Quimiorradioterapia , Quimioterapia Adjuvante , DNA Viral/sangue , Herpesvirus Humano 4/genética , Humanos , Incidência , Carcinoma Nasofaríngeo/epidemiologia , Carcinoma Nasofaríngeo/etnologia , Carcinoma Nasofaríngeo/etiologia , Neoplasias Nasofaríngeas/epidemiologia , Neoplasias Nasofaríngeas/etnologia , Neoplasias Nasofaríngeas/etiologia , Terapia Neoadjuvante/métodos , Recidiva Local de Neoplasia/terapia , Guias de Prática Clínica como Assunto , Radioterapia , Fatores de Risco , Terapia de Salvação/métodos , Resultado do Tratamento
4.
EBioMedicine ; 40: 327-335, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30642750

RESUMO

BACKGROUND: We aimed to identify a magnetic resonance imaging (MRI)-based model for assessment of the risk of individual distant metastasis (DM) before initial treatment of nasopharyngeal carcinoma (NPC). METHODS: This retrospective cohort analysis included 176 patients with NPC. Using the PyRadiomics platform, we extracted the imaging features of primary tumors in all patients who did not exhibit DM before treatment. Subsequently, we used minimum redundancy-maximum relevance and least absolute shrinkage and selection operator algorithms to select the strongest features and build a logistic model for DM prediction. The independent statistical significance of multiple clinical variables was tested using multivariate logistic regression analysis. FINDINGS: In total, 2780 radiomic features were extracted. A DM MRI-based model (DMMM) comprising seven features was constructed for the classification of patients into high- and low-risk groups in a training cohort and validated in an independent cohort. Overall survival was significantly shorter in the high-risk group than in the low-risk group (P < 0·001). A radiomics nomogram based on radiomic features and clinical variables was developed for DM risk assessment in each patient, and it showed a significant predictive ability in the training [area under the curve (AUC), 0·827; 95% confidence interval (CI), 0.754-0.900] and validation (AUC, 0.792; 95% CI, 0.633-0.952) cohorts. INTERPRETATION: DMMM can serve as a visual prognostic tool for DM prediction in NPC, and it can improve treatment decisions by aiding in the differentiation of patients with high and low risks of DM. FUND: This research received financial support from the National Natural Science Foundation of China (81571664, 81871323, 81801665, 81771924, 81501616, 81671851, and 81527805); the National Natural Science Foundation of Guangdong Province (2018B030311024); the Science and Technology Planning Project of Guangdong Province (2016A020216020); the Scientific Research General Project of Guangzhou Science Technology and Innovation Commission (201707010328); the China Postdoctoral Science Foundation (2016M600145); and the National Key R&D Program of China (2017YFA0205200, 2017YFC1308700, and 2017YFC1309100).


Assuntos
Imagem por Ressonância Magnética , Carcinoma Nasofaríngeo/diagnóstico , Neoplasias Nasofaríngeas/diagnóstico , Adulto , Biomarcadores , Terapia Combinada , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Estimativa de Kaplan-Meier , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/etiologia , Carcinoma Nasofaríngeo/mortalidade , Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/etiologia , Neoplasias Nasofaríngeas/mortalidade , Neoplasias Nasofaríngeas/terapia , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fluxo de Trabalho , Adulto Jovem
5.
Crit Rev Oncog ; 23(3-4): 219-234, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30311576

RESUMO

Epstein-Barr virus (EBV)-associated nasopharyngeal carcinoma (NPC) is one of the most common head and neck malignancies in southern China and Southeast Asia. Unfortunately, 70% of NPC patients have locally advanced disease at the first diagnosis. Radiotherapy alone and concurrent chemoradiotherapy are important treatment approaches for NPC, but they have a limited effect on patients with locally advanced or distantly metastatic disease. 1-5 Nevertheless, the unique immune environment of the EBV-associated NPC provides rational targets for immunotherapy. Diverse types of immunotherapies are actively being studied, including adoptive immunotherapy, therapeutic vaccines, immune checkpoint inhibitors, lytic-induction therapy, and viral immunotherapy. Specifically, adoptive immunotherapy with lymphocyte infusion was well tolerated and effective in 71.4% of patients combined with first-line chemotherapy. Several therapeutic vaccines and PD-1/PD-L1 pathway checkpoint inhibitors have shown promising clinic outcomes at phase I/II clinical trials. Moreover, EBV-lytic inducing therapy and viral immunotherapy for NPC are also being investigated. In this review, we summarized the current status, advantages, and disadvantages of each immunotherapy for EBV-associated NPC, which may shed light on developing safer and more effective treatment modalities in the future.


Assuntos
Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/virologia , Herpesvirus Humano 4 , Imunoterapia , Carcinoma Nasofaríngeo/etiologia , Carcinoma Nasofaríngeo/terapia , Animais , Vacinas Anticâncer/imunologia , Vacinas Anticâncer/uso terapêutico , Transformação Celular Viral , Células Matadoras Induzidas por Citocinas/imunologia , Células Matadoras Induzidas por Citocinas/metabolismo , Infecções por Vírus Epstein-Barr/imunologia , Herpesvirus Humano 4/fisiologia , Interações Hospedeiro-Patógeno/imunologia , Humanos , Imunomodulação , Imunoterapia/efeitos adversos , Imunoterapia/métodos , Imunoterapia Adotiva , Linfócitos do Interstício Tumoral/imunologia , Linfócitos do Interstício Tumoral/metabolismo , Terapia de Alvo Molecular/métodos , Carcinoma Nasofaríngeo/diagnóstico
6.
PLoS One ; 13(9): e0204568, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30265690

RESUMO

BACKGROUND: Nasopharyngeal carcinoma (NPC) is a race-specific malignancy. The nasal cavity is the main entry point for air pollutants or poisonous gases into the human body. However, the risk of NPC in populations exposed to air pollution remains unknown. METHODS: We combined data from the Taiwan Air Quality Monitoring Database (TAQMD) and the Longitudinal Health Insurance Database (LHID) to assess the risk of NPC in a population exposed to air pollution. RESULTS: Multivariate analysis revealed positive trends for the association between the risk of NPC and exposure to air pollution. After adjusting for potential covariates, the risk of developing NPC increased with the increase in nitrogen dioxide (NO2) and fine particulate matter (PM2.5) exposure concentrations from 1.39 to 2.28 and 2.01 to 1.97, respectively, compared to the risks at the lowest concentration levels. CONCLUSIONS: We identified a significant risk of NPC in a population exposed to air pollution. However, this study had several limitations. Moreover, additional experimental and clinical studies on the associations between environmental factors and NPC risk are warranted.


Assuntos
Poluição do Ar/efeitos adversos , Carcinoma Nasofaríngeo/etiologia , Adulto , Idoso , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Bases de Dados Factuais , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Monitoramento Ambiental , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Carcinoma Nasofaríngeo/epidemiologia , Dióxido de Nitrogênio/efeitos adversos , Dióxido de Nitrogênio/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Fatores de Risco , Dióxido de Enxofre/efeitos adversos , Dióxido de Enxofre/análise , Taiwan/epidemiologia , Adulto Jovem
7.
Sci Rep ; 8(1): 7052, 2018 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-29728581

RESUMO

We evaluated the reliability of early life nasopharyngeal carcinoma (NPC) aetiology factors in the questionnaire of an NPC case-control study in Hong Kong during 2014-2017. 140 subjects aged 18+ completed the same computer-assisted questionnaire twice, separated by at least 2 weeks. The questionnaire included most known NPC aetiology factors and the present analysis focused on early life exposure. Test-retest reliability of all the 285 questionnaire items was assessed in all subjects and in 5 subgroups defined by cases/controls, sex, time between 1st and 2nd questionnaire (2-29/≥30 weeks), education (secondary or less/postsecondary), and age (25-44/45-59/60+ years) at the first questionnaire. The reliability of items on dietary habits, body figure, skin tone and sun exposure in early life periods (age 6-12 and 13-18) was moderate-to-almost perfect, and most other items had fair-to-substantial reliability in all life periods (age 6-12, 13-18 and 19-30, and 10 years ago). Differences in reliability by strata of the 5 subgroups were only observed in a few items. This study is the first to report the reliability of an NPC questionnaire, and make the questionnaire available online. Overall, our questionnaire had acceptable reliability, suggesting that previous NPC study results on the same risk factors would have similar reliability.


Assuntos
Exposição Ambiental/efeitos adversos , Carcinoma Nasofaríngeo/epidemiologia , Carcinoma Nasofaríngeo/etiologia , Sistemas On-Line , Inquéritos e Questionários , Adolescente , Adulto , Fatores Etários , Estudos de Casos e Controles , Criança , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Sistemas On-Line/normas , Vigilância em Saúde Pública , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Inquéritos e Questionários/normas , Adulto Jovem
8.
Am J Epidemiol ; 187(10): 2117-2125, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-29701753

RESUMO

Because persistent inflammation may render the nasopharyngeal mucosa susceptible to carcinogenesis, chronic ear-nose-throat (ENT) disease and its treatment might influence the risk of nasopharyngeal carcinoma (NPC). Existing evidence is, however, inconclusive and often based on methodologically suboptimal epidemiologic studies. In a population-based case-control study in southern China, we enrolled 2,532 persons with NPC and 2,597 controls, aged 20-74 years, from 2010 to 2014. Odds ratios were estimated for associations between NPC risk and history of ENT and related medications. Any history of chronic ENT disease was associated with a 34% increased risk of NPC. Similarly, use of nasal drops or aspirin was associated with approximately doubled risk of NPC. However, in secondary analyses restricted to chronic ENT diseases and related medication use at least 5 years prior to diagnosis/interview, most results were statistically nonsignificant, except a history of uncured ENT diseases, untreated nasal polyps, and earlier age at first diagnosis of ENT disease and first or most recent aspirin use. Overall, these findings suggest that ENT disease and related medication use are most likely early indications rather than causes of NPC, although the possibility of a modestly increased NPC risk associated with these diseases and related medications cannot be excluded.


Assuntos
Carcinoma Nasofaríngeo/epidemiologia , Neoplasias Nasofaríngeas/epidemiologia , Otorrinolaringopatias/complicações , Adulto , Idoso , Aspirina/efeitos adversos , Estudos de Casos e Controles , China/epidemiologia , Doença Crônica , Feminino , Humanos , Modelos Logísticos , Masculino , Medicina Tradicional Chinesa/efeitos adversos , Pessoa de Meia-Idade , Análise Multivariada , Carcinoma Nasofaríngeo/etiologia , Neoplasias Nasofaríngeas/etiologia , Razão de Chances , Otorrinolaringopatias/tratamento farmacológico , Fatores de Risco , Adulto Jovem
9.
Cancer Med ; 7(4): 1110-1117, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29493874

RESUMO

Circulating plasma Epstein-Barr virus DNA (EBV DNA) is related to tumor recurrence and metastasis and has potential as a dynamic, sensitive, and specific marker in nasopharyngeal carcinoma (NPC). We investigated the clinical significance of assessing plasma EBV DNA load at various time points during treatment. Patients with NPC (n = 949) for whom plasma EBV DNA load was measured by real-time quantitative polymerase chain reaction (RT-qPCR) before treatment (pre-EBV) and at midtreatment (mid-EBV), end of treatment (end-EBV), and 3 months after completing treatment (3 m-EBV) were retrospectively assessed. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal EBV DNA cutoff point for each time point. Overall survival (OS), distant metastasis-free survival (DMFS), and progression-free survival (PFS) were compared using Kaplan-Meier estimates. High pre-EBV, high mid-EBV, high end-EBV, and high 3 m-EBV were all associated with significantly poorer OS, DMFS, and PFS in the entire cohort. Detectable end-EBV and 3 m-EBV was associated with significantly poorer OS, DMFS, and PFS. Among patients with detectable end-EBV, adjuvant therapy significantly improved OS (HR 2.419; 95% CI 1.297-4.51, P = 0.03) and DMFS (HR 2.45; 95% CI 1.243-4.828, P = 0.04), but not PFS (P = 0.17). EBV DNA represents a dynamic biomarker for monitoring treatment and predicting survival in NPC. Assessing plasma EBV DNA before, during, and after chemoradiotherapy could be clinically valuable and enable selection of patients most likely to benefit from additional therapy and improve assessment of treatment response and disease surveillance. Further multicenter prospective investigations are warranted.


Assuntos
DNA Viral , Infecções por Vírus Epstein-Barr/virologia , Herpesvirus Humano 4/genética , Carcinoma Nasofaríngeo/sangue , Carcinoma Nasofaríngeo/mortalidade , Carga Viral , Adolescente , Adulto , Idoso , Biomarcadores , Criança , Terapia Combinada , Infecções por Vírus Epstein-Barr/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/etiologia , Carcinoma Nasofaríngeo/terapia , Estadiamento de Neoplasias , Estudos Retrospectivos , Adulto Jovem
10.
Cancer Med ; 7(4): 1458-1467, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29479857

RESUMO

Nasopharyngeal carcinoma (NPC), which is closely associated with Epstein-Barr virus (EBV), is one of the most prevalent cancers in southeast China. Most NPC patients are diagnosed at late stage due to inconspicuous symptoms at the early stage, and the prognosis of these patients is poor. The early diagnosis rate of NPC could be significantly increased by serological screening, but the positive predictive value (PPV) is relatively low. A simple two-step serological screening scheme was established to improve the PPV of the screening strategy and was validated by a prospective cohort. Serum antibodies specific for EBNA1, Zta, Thymidine Kinase (TK), EAD, EAR, and VCA were detected by enzyme-linked immunosorbent assay. The combination of EBNA1/IgA and VCA/IgA was used in the first step of screening, and anti-early antigens (EAs) were used in the second step of screening. EAD/IgA was the most prominent marker in the second step of screening, and other anti-EAs were complementary to EAD/IgA. As validated by a prospective cohort including 4200 participants, using the combination of EAD/IgA and TK/IgA in the second step decreased the number of high-risk participants from 128 to 27, and increased the PPV from 4.69% to 18.52%, with only one very early-stage case missed. The two-step screening scheme provides a standardized approach for NPC screening with an improved PPV and may be used in future field studies. With this two-step serological screening method, more people benefit from the screening program without increasing the need for fiberoptic endoscopy.


Assuntos
Carcinoma Nasofaríngeo/sangue , Carcinoma Nasofaríngeo/epidemiologia , Anticorpos Antivirais/sangue , Biomarcadores , Biópsia , Humanos , Imunoglobulina A/imunologia , Programas de Rastreamento , Carcinoma Nasofaríngeo/diagnóstico , Carcinoma Nasofaríngeo/etiologia , Vigilância da População , Curva ROC , Medição de Risco , Fatores de Risco , Testes Sorológicos
11.
Int J Cancer ; 143(3): 610-620, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29468660

RESUMO

Nasopharyngeal carcinoma (NPC) is an Epstein-Barr virus (EBV)-associated lymphoepithelioma. The aim of this study was to characterize the homogeneity and distinctness of the T-cell repertoires within and between primary and metastatic NPCs. We used ultra-deep sequencing of the hypervariably rearranged antigen-binding CDR3 regions of T-cell receptor beta (TCRbeta ) to comprehensively profile the T-cell repertoires in NPC patients receiving definitive chemoradiotherapy with long-term follow-up. We observed not only various spatially heterogeneous patient-specific TCRbeta clone compositions that changed with time but also several commonly enriched TCRbeta subclones that were constantly shared between primary NPCs in the head and neck regions, locally recurrent tumors after treatment and later-developed distant metastatic tumors in the liver, lung and bone. Comparison of the overlap frequency of the T-cell clonality between TCRbeta repertoires enabled us to calculate the pairwise genetic distance between primary NPCs of different patients and different sites of metastatic or recurrent NPCs. The constructed NPC phylogeny clearly differentiated the low-risk patients without relapse from the high-risk patients with distant metastasis after chemoradiotherapy. In contrast to the rather low frequency of nonsilent somatic mutations in NPC cells, the degrees of similarity and divergence of NPC-infiltrating lymphocyte TCRbeta repertoires among different patients showed prognostication. Moreover, the persistent presence of commonly NPC-shared in-frame TCRbeta CDR3 gene sequences spatiotemporally identified in the NPC-infiltrating lymphocytes within varied EBV-positive NPCs and their metastases suggest the existence of frequently shared epitopes of neoantigens virally or nonvirally displayed on cancer cells, thereby providing opportunities for the development of precisely tumor-targeted immunotherapy for distant metastasis.


Assuntos
Infecções por Vírus Epstein-Barr/complicações , Carcinoma Nasofaríngeo/etiologia , Carcinoma Nasofaríngeo/patologia , Neoplasias Nasofaríngeas/etiologia , Neoplasias Nasofaríngeas/patologia , Receptores de Antígenos de Linfócitos T alfa-beta/genética , Idoso , Biomarcadores , Biópsia , Evolução Clonal , Infecções por Vírus Epstein-Barr/virologia , Humanos , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/diagnóstico por imagem , Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/terapia , Metástase Neoplásica , Estadiamento de Neoplasias , Recidiva
12.
Clin Cancer Res ; 24(6): 1305-1314, 2018 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-29301829

RESUMO

Background Epstein-Barr virus (EBV) is necessary for the development of nasopharyngeal carcinoma (NPC). By adulthood, approximately 90% of individuals test EBV-positive, but only a fraction develop cancer. Factors that identify which individuals are most likely to develop disease, including differential antibody response to the virus, could facilitate detection at early stages when treatment is most effective.Methods We measured anti-EBV IgG and IgA antibody responses in 607 Taiwanese individuals. Antibodies were measured using a custom protein microarray targeting 199 sequences from 86 EBV proteins. Variation in response patterns between NPC cases and controls was used to develop an antibody-based risk score for predicting NPC. The overall accuracy [area under the curve (AUC)] of this risk score, and its performance relative to currently used biomarkers, was evaluated in two independent Taiwanese cohorts.Findings Levels of 60 IgA and 73 IgG anti-EBV antibodies differed between stage I/IIa NPC cases and controls (P < 0.0002). Risk prediction analyses identified antibody targets that best discriminated NPC status-BXLF1, LF2,BZLF1, BRLF1, EAd, BGLF2, BPLF1, BFRF1, and BORF1. When combined with currently used VCA/EBNA1 IgA biomarkers, the resulting risk score predicted NPC with 93% accuracy (95% CI, 87%-98%) in the general Taiwanese population, a significant improvement beyond current biomarkers alone (82%; 95% CI, 75%-90%, P ≤ 0.01). This EBV-based risk score also improved NPC prediction in genetically high-risk families (89%; 95% CI, 82%-96%) compared with current biomarkers (78%; 95% CI, 66%-90%, P ≤ 0.03).Interpretation We identified NPC-related differences in 133 anti-EBV antibodies and developed a risk score using this microarray dataset that targeted immune responses against EBV proteins from all stages of the viral life cycle, significantly improving the ability to predict NPC. Clin Cancer Res; 24(6); 1305-14. ©2017 AACR.


Assuntos
Anticorpos Antivirais/imunologia , Detecção Precoce de Câncer , Infecções por Vírus Epstein-Barr/imunologia , Herpesvirus Humano 4/imunologia , Carcinoma Nasofaríngeo/diagnóstico , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Detecção Precoce de Câncer/métodos , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/virologia , Feminino , Humanos , Imunoglobulina A/sangue , Imunoglobulina A/imunologia , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/epidemiologia , Carcinoma Nasofaríngeo/etiologia , Estadiamento de Neoplasias , Curva ROC , Medição de Risco , Taiwan/epidemiologia , Adulto Jovem
13.
Eur J Cancer Prev ; 27(1): 33-41, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-27748661

RESUMO

Among all cancers, the incidence of nasopharyngeal carcinoma (NPC) is quite high in the endemic regions. NPC is a head and neck cancer with poor survival rate, and is rare throughout most of the world but common in certain geographic areas, like southern Asia and some regions of North East India (Nagaland, Manipur, and Mizoram). A clear understanding of its etiology is still lacking, but NPC is widely suspected to be the result of both genetic susceptibility and exposure to environmental factors or Epstein-Barr virus infection. Diagnosis in the early stages needs a high index of clinical acumen, and, although most cross-sectional imaging investigations show the tumor with precision, confirmation is dependent on histology. This article reviews all related research reports on NPC histopathological classifications worldwide that have been published within the past 20 years. Genome-wide association studies suggested that there might be common disease mechanisms between that disease and NPC. Personalized management rules, quality assessment of life in patients, and an understanding of the essential mechanisms of recurrence could be directed toward research into recurrent NPC. Hence, this literature would offer otolaryngologists a deeper insight into the etiological and management aspects of NPC.


Assuntos
Exposição Ambiental/efeitos adversos , Predisposição Genética para Doença , Carcinoma Nasofaríngeo/etiologia , Neoplasias Nasofaríngeas/etiologia , Ásia/epidemiologia , Doenças Endêmicas , Infecções por Vírus Epstein-Barr/epidemiologia , Infecções por Vírus Epstein-Barr/virologia , Herpesvirus Humano 4/isolamento & purificação , Herpesvirus Humano 4/patogenicidade , Humanos , Incidência , Carcinoma Nasofaríngeo/epidemiologia , Neoplasias Nasofaríngeas/epidemiologia , Prevalência
14.
Gulf J Oncolog ; 1(24): 70-74, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28798007

RESUMO

INTRODUCTION AND OBJECTIVES: Nasopharyngeal Carcinoma represents 0.7% of the total cancer cases in the world with an ASR index of 1.7 and is widely associated with Epstein-Barr virus. It is not common in Italy (ASR index of 0.5) while in China (ASR 1.9), one third of the clinical cases are observed in Guangdong (ASR index 11.3). It is also quite common in Malaysia and Indonesia. The activation of the cancerogenesis process happens after the exposure to some environmental parameters that epidemiological studies have indicated with various dietary habits, mainly for salted fish consumption. The purpose of this work is to highlight such as exposure to compounds, such as formaldehyde, which is present in the different working conditions of these countries and may lead to the real cause to establish the carcinogenic process. MATERIALS AND METHODS: The most recent publications regarding the impact of various external factors on Pub Med, Google, TOXLINE, Chem Abstract, were analyzed with the radiological data that were found in Milan hospitals database. RESULTS: The relationship between food consumption and nasopharyngeal cancer are not clear and statistically insignificant in Indonesia. In Malaysia, the preparation of natural rubber for the use of formaldehyde is a dangerous environmental factor. The same exposure is a risk factor in Guangdong, where many workers are employed in the wood panel industry. Incidence of cancer in these Chinese ethnic groups decreases when they migrate to other countries. In the last 5 years, few cases were recorded in Italy, without any apparent change in ethnic environmental factors or HBV infection Discussion: In the production of natural rubber, a lot of people are exposed to formaldehyde during the various steps of preparation and production such as stripping, drying and coagulation without observing proper environmental hygiene precautions. The same working conditions are present in industrial production of wood panels in Guangdong, China. The relationship between exposure to formaldehyde and nasopharyngeal cancer is demonstrated by the fact that epidemiological studies on the population of this Chinese district whose immigrant populations were not exposed to these pollutants, the appearance of these tumors decreases. Also an examination of our radiological data in Italy shows that in about one hundred sixty cases of nasopharyngeal cancer none of the patients were Indonesian or Chinese Conclusion: The preliminary results of our study suggest that EPST-BARR virus could be a risk factor if associated with exposure to compounds such as formaldehyde which is present in industrial productions of countries like Indonesia, Malaysia, and China.


Assuntos
Poluentes Ambientais/efeitos adversos , Poluição Ambiental/efeitos adversos , Carcinoma Nasofaríngeo/etiologia , Neoplasias Nasofaríngeas/etiologia , Exposição Ocupacional/efeitos adversos , Contaminação de Alimentos , Humanos , Indústrias
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