Nasopharyngeal carcinoma (NPC) is one of the most common malignant tumors in China. It has its highest incidence rate in south China whose central region is Guangdong (Canton) Province where Cantonese is spoken. The perpose of this paper is mainly to describe the present status of NPC in China considering the following two main factors; 1. Epidemiologic character: Obvious geographic accumulation, susceptility of the population, an aggregation in certain families and a stabilization of the incidence rate were observed. 2. Etiology: The Epstein-Barr virus (EBV) is suspected to play an important role in the occurance of NPC. However, whether EBV is the only causative factor of NPC should be studied further. EBV may have a synergistic relationship with environmental pathogenic factors. Genetic susceptivity was closely related to NPC. Searching and isolating the oncogene and tumor suppressor gene is one of the most important molecular pathogenic mechanisms of NPC. Such genes reacting to NPC in China have been reported to be ras, c-myc, c-erB-2 and RB, p53, p16, etc. In addition, the expression of the TX gene has also been studied. 3. Early diagnosis: From 1986 to 1995, a longitudinal survey was completed on a cohort consisting of about 100, 000 subjects in the high risk area for NPC in Guangdong Province. A high risk population optimum screening program for NPC was proposed, and the criteria for both high risk populations and precancerous lesions of NPC were established and thus helped to detect NPC at earlier stage and thus individuals are found at a precancerous status. 4. Clinical stage: Compared with UICC (draft, 1996), the NPC new stage, proposed in 1992 in China, seems to be a more reasonable TN classification since it not only considers such factor as the aggressive degree of NPC but also is able to predict the prognosis and guide the therapy better. These twostaging systems are correlated to some extent to each other. 5. Therapy: The primary treatment for NPC is radiotherapy. Great progress has been made in different fractional therapy and individual therapeutic schemes. Three-dimentional conformal radiotherapy is a new treatment modality which improves the therapeutic technique of radiotherapy for NPC. In addition, it also helps to improve the survival rate and the quality of life (QOL) in patients undergoing chemotherapy as well as surgical operations at different stages of NPC. Recently, blocking precancerous lesions by drug and gene therapy is considered to be the key of research for NPC, and some progress has already been made in the field in China.

View full abstract

A total of 17 patients with hypopharyngeal and cervical esophageal carcinoma were treated at the Sun Yat-sen University of Medical Science (SUMS) Memorial Hospital, China from 1992 to 1996. According to the UICC classification (1987), 15 of the cases were advanced cases at either stage III or stage IV. Before operation, 10 cases (59%) were confirmed to have cervical lymph node metastasis. A total of 17 cases underwent a radical operation and primary reconstruction for lesions of the hypopharyngoesophagus using the residual mucosa (2 cases), forearm flap (1 case), vastus lateralis flap (2 cases), jejunal graft (1 case) and gastric tube (11 cases). A unilateral neck dissection and thyroidectomy were performed with the excision of the carcinoma in 11 cases and 5 cases, respectively. All patients received postoperative radiotherapy. In 17 patients, 10 cases (59%) survived, 6 cases (35%) died of carcinoma and 1 case (5.9%) died due to postoperative complication. In those who survived, the follow-up time after operation ranged from 14 to 62 months. The one-year, two-year and three-year survival rates were 88 % (15/17), 73% (8/11) and 60% (3/5), respectively. The long-term survival rate has yet to be determined and shoud be carefully observed in the followed up.

View full abstract

Two patients with acoustic neuroma presenting with sudden hearing loss as the initial symptom are herein reported. Case 1, a 32-year-old male presented with sudden hearing loss and tinnitus of the left ear. A pure tone hearing test showed a slight sensorineural hearing loss on the left side, based on a trough type audiogram (40 dB at 1000 Hz). MR imaging demonstrated a tumor measured 2 cm from the left internal auditory meatus to the cerebellopontine angle. The tumor is planning to be treeted treated by gamma knife radiosurgery. Case 2, a 43-year-old male presented with sudden hearing loss of the right ear accompanied by tinnitus and episodic vertigo. A pure-tone hearing test showed severe sensorineural hearing loss. In the examination of the vestibule function, a clock wise rotatory nystagmus was observed, with no change when the position of head was altered. A tumor measured less than 1cm was confirmed in the right internal auditory meatus by MRI. The hearing significantly improved after the therapy. As a result, no surgical therapy was necessary. The patient is still being followed up.

View full abstract

We conducted an epidemiological investigation on nasal allergy in China and Japan. A prevalence survery was done on nasal allergy in a total of 9651 young people: including 2590 cases in Lili Town, Wujiang City, Jiangsu, Nanjing Medical University and Sun Yat-Sen University of Medical Seiences, China; and 7061 cases in Shiraoi-cho, Hokkaido, Kuriyama and Sendai, Japan. The prevalence of nasal allergy in China was lower than that in Japan. The differences in the prevalence of nasal allergy were thought to be due to an imbalance of social and economic development and not due to racial difference. Japanese remarkable economic development has led to a significant increase in nasal allergy in Japan. The positive rate of the scratch test and the prevalence of nasal allergy in China have also shown a recent tendency of increase due to its rapid economic development. It will be interest to see if the rate of nasal allergy in China continues to increase along with the progressive improvement in Chinese economic development.

View full abstract

It has been suggested that decreesive tendeucy of parasites may have caused the rapid increase in nasal allergies in Japan in recent years. In China investigations were carried out based on stool examinations, IgE antibody mesurements, and the number of eosinophil leukocytes. As a result, the following four factors became clear: The prevalence rate of nasal allergy is low. The parasitic infection rate is also not very high. Neither the serum IgE antibody value nor the number of the eosinophil leukocites tend to increase very much in cases of parasitic infection. In addition, in cases of parasitic infection, the number of positive responses to the allergen skin test is not so small. In addition to clinical cases, parasitic infection is not thought to necessary cause nasal allergy. Based on these findings there is little evidence to support the hypothesis that an increase in such infections after the Second world War have led to the increase in nasal allergy in Japan. Our findings suggest that the prevalence of nasal allergy appears to be due to an increase in the number of allergen. The increased number of cedar trees is known to have caused increased pollinosis in Japan and since the same tree species also exists in China, the presence of such cedar trees could possibly cause pollinosis in China in the future as well.

View full abstract