Prognostic Significance of the Microvessel Density in Nasopharyngeal Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The nasopharyngeal cancer (NPC) of nasopharyngeal neoplasms is a rare disease with a relatively poor prognosis, because they tend to be diagnosed in the far advanced stage. Therefore, radiotherapy had been the treatment of choice. Angiogenesis is a crucial step in the tumor growth and progression. The authors attempted to investigate the prognostic value of the microvessel density in NPC. SUBJECTS AND METHOD: We analyzed tumor tissues from 57 cases of paraffin block specimens which had been diagnosed with NPC and treated at Chonnam National University Hospital. The anti-human von Willebrand factor antibody was used to determine the microvessel density (MVD). RESULTS: The MVD was 48.5 in the early stage (stage I and II) and 51.2 in the advanced stage (stage III and IV), which were not statistically significant (p=0.057). The MVD was 55.3 in type I, 54.4 in type II, and 41.8 in type III, and there were no statistical significance between these values (p=0.36). The MVD was not statistically significant between T and N stages (p=0.26, 0.42). There was no significance between the MVD and the survival rates (p>0.05). CONCLUSION: The results suggest that the MVD was not a prognostic significance in NPC.

Prognostic Significance of Expression of Glutathione S-Transferase-pi and Multidrug Resistance-Associated Protein in Nasopharyngeal Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For the treatment of nasopharyngeal carcinoma (NPC), radiation therapy is a primary option. Because of distant metastasis and the high incidence of a locoregional failure following radiotherapy, the combined treatment modality with chemotherapy is applied, although resistance to chemotherapy makes chemotherapy less effective. The Cisplatin-based chemotherapy has been widely used in the field of nasopharyngeal cancer. The Cisplatin resistance is known to be caused by the multidrug resistance-associated protein (MRP), which is one of the drug-export pumps and the glutathione S-transferase (GST)-pi which catalyzes the conjugation of the GSH (glutathione) and the cisplatin. The aim of this study is to determine the predictive value of GST-pi and MRP upon the response to cisplatin in nasopharyngeal carcinoma. SUBJECTS AND METHOD: We analyzed tumor tissues from 49 cases of paraffin block specimens which were diagnosed with NPC and treated at Chonnam National University Hospital. The immunohistochemical study for the GST-pi and the MRP was performed with paraffin block specimens of nasopharyngeal cancers. RESULTS: In the GST-pi, the relationship between the early stage (64.3%) and the advanced stage (91.4%) was statistically significant (p=0.020). The expression of the GST-pi and the MRP had no relationship with the clinical factor, the response to chemotherpy and the survival rate. CONCLUSION: Because the expression of the GST-pi and the MRP in the nasopharyngeal carcinoma could not predict the response to chemotherapy. So the efforts to find the predictive value of the chemotherapy are needed.

Prognostic Significance and Treatment Outcomes of Combination of Radiotherapy and Chemotherapy in Nasopharyngeal Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: T he diagnosis of a nasopharyngeal carcinoma is frequently made at an advanced stage. The anatomic complexicity of the nasopharynx makes a surgical approach difficult, so the radiation therapy is traditionally used as a primary option. Because of the high incidence of a locoregional failure following the radiotherapy and the distant metastasis, the combined treatment modality with the chemotherapy has been applied. The author attempted to investigate the clinical characteristics and the treatment outcomes of nasopharyngeal cancer patients treated with the combination of the radiotherapy and the chemotherapy. SUBJECTS AND METHOD: We retrospectively analyzed 82 patients who were diagnosed with the nasopharyngeal carcinoma in Chonnam National University Hospital. RESULTS: The cumulative survival rates for a 5-year period were 42%. The pathologic type, the clinical stage, the cranial nerve invasion, and the response to the radiotherapy were related to the survival rate of the Kaplan-Meier test (p<0.05). In the Cox proportional hazard model, only the response to radiotherapy was related to the survival rate (p=0.05), as the clinical stage wasn't (p=.06). In the multivariate analysis between the responses to radiation and the clinical factor, the histological type (p=0.018) and the response to the chemotherapy (p=0.021) was statistically significant. CONCLUSION: The response to radiation is the most important in the patient's survival. The clinical stage is a probable prognostic factor. Factors affecting the response to radiation are the histological type and the response to chemotherapy.