抄録
It is considered that nonkeratinizing or undifferentiated squamous cell carcinoma in nasopharynx (NPC) is intimately correlated with Epstein-Barr Virus (EBV). 21 patients with NPC were followed in Kyoto University Hospital and 4 in Osaka red cross hospital during the past 2 years from 1980 to 1981. These patients were classified histopathologically according to WHO classification by Shanmugaratham in 1978 and staged with TNM classification in UICC in 1978.
The incidence rate of NPC among the head and neck tumor is 5.6% in our university from 1980 to 1981. The sex ratio of male to female is nearly equal. The stages of III and IV occupy 76% and both of nonkeratinizing and undifferentiated carcinoma predominate 84% of all NPC. The mean age of NPC patients is 56.7 years old.
Sera from these 25 patients with nasopharyngeal carcinoma were collected at intervals of 3 to 8 months over 2 years and examined for their spectra and titers of antibodies of EBV-related antigens. They were titrated for IgG, IgA and IgM antibodies to EB viral capsid antigen (VCA), for IgG and IgA antibodies to early antigen-DR component (EA) and for antibodies to EBV-associated nuclear antigen (EBNA).
All of these patients were primarily treated with radiation, a few of whom did not responded to this therapy and were subsequently treated with surgery or chemotherapy.
EBV antibodies of VCA-IgG, IgA, EA(DR)-IgG, IgA and EBNA were elevated in 73% and 90% of the nonkeratinizing or undifferentiated NPC patients respectively. That of VCA-IgM was never elevated in almost all the cases.
In contrast to this, those were all in a normal range in the NPC patients with keratinizing squamous cell carcinoma and malignant lymphoma. Also 9% and 10% of nonkeratinizing and undifferentiated carcinoma showed the normal ranges of EBV antibodies, possibly indicating the non-association with EBV.
When NPC disappeared with radiation therapy, EBV antibodies became normalized for 6-18 months. However, those whose NPC did not respond to the combined therapy with radiation, surgery and chemotherapy maintained the high titers of EBV antibodies.
The prognosis was the poorest in the patients with undifferentiated carcinoma, 40% of whom died within 4 years after the diagnosis.
