The efficacy of fiberoptic endoscopic examination and biopsy in the detection of early nasopharyngeal carcinoma

Article Abstract:

Nasopharyngeal carcinoma is a form of cancer that is far more common in Asia than in the United States. In southern China, the disorder affects 20 people per 100,000 population. Unfortunately, the early symptoms of nasopharyngeal carcinoma seem trivial, and the disease is often quite advanced by the time the patient seeks medical attention. As is the case for many cancers, early diagnosis means a better chance for successful treatment and survival. In the past, the nasal cavity and pharynx (the back of the mouth where the nasal and oral cavities become one) could be observed for signs of abnormality using a mirror. Abnormal tissue could be removed with a forceps for further examination. Now, however, the availability of endoscopic equipment is changing this approach. Using an endoscope, the physician can easily examine the pharynx. (An endoscope is a flexible tube with a fiberoptic device for viewing the inside of the body.) Furthermore, the removal of a biopsy specimen is made easier by the improved viewing conditions. A new endoscopic biopsy technique has been developed for the examination of patients at high risk for nasopharyngeal cancer. The technique was tested on 130 patients, all of whom had been previously found to have antibodies to Epstein-Barr virus in their nasal and oral secretions, an important risk factor for this cancer. Patients with obvious tumor growth were not included in the study. Six different regions of the nasopharynx were sampled in each patient for a total of 780 biopsies. Results revealed that 11 biopsies were positive for nasopharyngeal carcinoma; these 11 biopsies were obtained from 7 patients. The findings indicate that endoscopic examination itself is not enough to identify all abnormal tissues in the nasopharyngeal cavity, but careful sampling of tissues can demonstrate the presence of cancer. Further research may find ways to make the combination of endoscopic examination and biopsy more effective in the detection of nasopharyngeal carcinoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Nasopharyngeal carcinoma: pattern of tumor regression after radiotherapy

Article Abstract:

Nasopharyngeal carcinoma, a cancer of the nose and mouth cavity which is more common among Asians, is generally treated with radiotherapy. Unfortunately, a local relapse is not rare, and the prognosis for relapsed patients is poor. To document the response of nasopharyngeal carcinoma to radiotherapy and to identify the patients who might benefit from a booster dose of radiation, a series of biopsies were taken from 50 patients with histologically confirmed disease. The results indicated that biopsies guided by endoscopic examination were more accurate than those guided by mirror examination. The probability of obtaining a biopsy positive for nasopharyngeal carcinoma was very high in the weeks immediately following the radiation treatment. The probability that a positive biopsy at four weeks would later become a negative one (free of cancer) was quite high, and the results suggest that the biopsies should not be performed for at least 10 weeks after the initial radiotherapy. It is uncertain whether the patients with positive biopsies at 10 weeks are truly prime candidates for recurrence or merely have more slowly regressing tumors. Further study will be necessary to determine if further intervention at 10 weeks has a beneficial effect on patient survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Radiotherapy

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Fiberoptic endoscopic examination and biopsy in determining the extent of nasopharyngeal carcinoma

Article Abstract:

In this prospective study, 75 new patients with nasopharyngeal carcinoma were examined with a fiberoptic endoscope as a part of the evaluation procedure. In three patients, the tumor was so extensive as to fill the nasal cavity. In the remaining 72 patients, biopsy specimens were taken from six standard sites. The endoscopic and biopsy findings were compared. A high incidence of false positive (a report of disease when tissue is healthy) endoscopic examinations occurred; all were in patients with exophytic tumors which can be easily differentiated from normal tissues. Numerous false negative (a report of healthy tissue when disease had occurred) endoscopic observations occurred as well; the regions in question were often in parts of the pharynx which were observed head-on rather than at an oblique angle. In addition, submucosal growth of tumor documented by biopsy could not be observed by endoscope examination. Biopsies are clearly superior than endoscopic examination for the evaluation of pharyngeal carcinoma. In addition, biopsy should be performed in those cases where pharyngeal carcinoma is suspected on the basis of metastatic carcinoma in the lymph nodes of the neck. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis

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