Vol.103 No.3 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 103 No. 3 March 2010
Diagnosis and Treatment of Nasopharyngeal Carcinoma Based on Biological Feature
Tomokazu Yoshizaki
(Kanazawa University)
Nasopharyngeal carcinoma (NPC) is located in the highest portion of the pharynx, and is thus located near the skullbase. It encounters various anatomical structures such as the internal carotid artery and demonstrates intracranial invasion via the anatomical course of these vessels and nerves. In addition, NPC shows highly metastatic features, which are mainly attributable to Epstein-Barr virus (EBV) gene expressions. Especially, LMP1, an EBV primary oncogene, upregulates metastatic multisteps. Also, inactivation of the apoptotic pathway by the EBV gene reserves the normal cellular signal transduction for apoptosis which is inactivated by gene mutations in usual head and neck cancer. Thus, NPC is sensitive to apoptosis inducing treatment such as chemotherapy and radiotherapy. Moreover, EBV could be a therapeutic target for NPC. Treatment of NPC with the anti-viral agent cidofovir showed prolonged disease control. These exploratory studies were based on clinical observations. NPC still has many unsolved features. How EBV infects epithelial cells? Why does the immune system allow them to stay in cancer cells? The clues to solve these questions may also lie in the daily clinical observation.
Key words :nasopharyngeal carcinoma, Epstein-Barr virus, metastasis, epithelial mesenchymal
transition, molecular targetting