Biopsies and Detection of Nasopharyngeal Cancer in a High-Risk Population

• Main Authors: Nasopharyngeal Brush, Cathryn E. Tune, Jeremy L. Freeman, Thomas Shpitzer, Jeroen D. F, David Payne, C. Irish Raymond Ng, Cheung Hans-michael Dosch
• Other Authors: The Pennsylvania State University CiteSeerX Archives
• Format: Text
• Language: English
• Subjects: Pacific; inuit
• Online Access: http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.512.2111; http://jnci.oxfordjournals.org/content/91/9/796.full.pdf

noma (NPC) is an important tumor in many countries. Ethnic and regional factors strongly influence disease risk. NPC is usually diagnosed late in disease development, and 10-year survival rates are as low as 10%. Epstein-Barr virus (EBV), a possibly causative agent, is present in all cells of essentially all undifferentiated NPCs. We wished to determine the following: 1) whether an ambulatory nasopharyngeal brush bi-opsy could provide sufficient tumor cell DNA for the detection of EBV and 2) whether the detection of EBV in this locale reflects the presence of tumor cells or simply EBV carrier status. Methods: We collected nasopharyngeal tissue via ambulatory brush biopsies from 21 patients with newly diagnosed NPC and from 157 subjects with other otolaryngologic complaints. The major-ity of study subjects were from high-risk populations. Sample DNA was analyzed for the presence of EBV ge-nomic sequences by use of the polymer-ase chain reaction (PCR). Results: Ninety-six percent of samples yielded sufficient DNA for PCR amplification. Nineteen of 21 patients with NPC brushed positive for EBV DNA, while all but two (1.3%) of 149 informative control subjects were negative for EBV (two-sided P<.0001). One of the EBV-positive control subjects had an EBV-positive inverted sinonasal papilloma; the other EBV-positive control subject exhibited no overt clinical disease. Con-clusion: Demonstration of EBV DNA in nasopharyngeal brush biopsy speci-mens detects NPC with a sensitivity of at least 90 % (95 % confidence interval = 89.63%–91.32%) and a specificity of approximately 99 % (95 % confidence interval = 98.64%–98.68%). This tech-nique merits further testing as a pos-sible ambulatory screening strategy in high-risk populations. [J Natl Cancer Inst 1999;91:796–800] Nasopharyngeal carcinoma (NPC) is a relatively rare tumor in Caucasians, but it occurs at high frequency in Pacific and Mediterranean rim countries, among the Inuit, and in coastal regions of Africa. NPC has strong genetic and environmen-tal roots (1); e.g., ...