ABSTRACT
The present study was designed to evaluate serum levels of osteopontin [OPN], tumor necrosis factor-alpha [TNF-alpha] and interleukin-[IL]-6 in pre-treatment samples obtained from patients with biopsy confirmed nasopharyngeal carcinoma [NPC]. The study included 28 NPC patients; 20 males and 8 females with mean age of 56.8 +/- 8 years. Cervical lymphadenopathy was the main presenting symptom in 19 patients [67.9%], recurrent unexplained attacks of epistaxis in 16 patients [57.1%] and 7 patients [25%] had secretory otitis media. Patients were clinically categorized using TNM staging and underwent nasopharyngoscopy and biopsy taking for pathological examination and grading according to the World Health Organization [WHO] types. All patients received chemo-radiotherapy and completed their follow-up at ENT outpatient clinic. Pre-and post-treatment blood samples were collected for estimation of serum level of osteopontin [OPN], tumor necrosis factor-a [TNF-alpha] and interleukin-[lL]-6. Blood samples were obtained from 10 healthy volunteers as control group. Pretreatment serum levels of estimated parameters were significantly higher compared both to control levels and to post-treatment levels. However, despite treatment induced significant decrease of serum levels of estimated parameters, their levels still significantly higher compared to control levels. There was a positive significant correlation between TNM clinical staging and serum levels of OPN, TNF alpha and IL-6, Also, WHO pathological types showed a positive significant correlation with serum levels of OPN and lL-6, but the correlation with TNF-alpha was positive non-significant. Using ROC analysis for estimated parameters as screening test for WHO type I lesions defined estimation of serum OPN as a good screening test to detect early lesions and defined 2 cutoff points for serum OPN; namely: 265 and 298 ng/ml, had identical screening power however, cutoff point at 265 ng/ml showed significantly higher of sensitivity rate [89.3%]. NPC is associated with immune dysregulation in favor of Th1 side and elevated OPN pre-treatment serum levels that could be used as screening test for early cases of NPC as a preliminary screening test with cutoff point at 265 ng/ml as discriminative value