The role of nasopharyngeal examination and biopsy in the diagnosis of malignant diseases / O papel do exame clínico e da biópsia de nasofaringe no diagnóstico de doenças malignas

Abstract Introduction: In direct proportion to the increasing rate of nasopharynx examinations applied, the early diagnosis and treatment of lesions in this region is possible. At times the clinical findings and the biopsy results are not consistent, so biopsies may have to be repeated. Objectives: The aim of this study was to evaluate the distribution of pathology test results obtained from cases of nasopharynx biopsy, to determine with which methods determination most often was made, and to investigate which kinds of cases required the biopsy to be repeated. Methods: The study included a total of 1074 patients (500 female, 574 male) who underwent nasopharyngeal biopsy in our clinic between June 2011 and June 2017. Data were obtained from patient records of age, gender, clinical findings, imaging findings if available and pathological diagnosis. The pathological diagnoses were separated into 3 main groups as chronic nasopharyngitis, benign cytology and malignant cytology. Results: The examinations resulted in 996 cases reported as chronic nasopharyngitis, 47 as benign cytology and 31 as malignant cytology. Of the 31 malignant lesions, diagnosis was made in 15 patients (48.4%) with a single biopsy, and in 16 patients (51.6%), as a result of the pathology report when 2 or more biopsies were taken. In the comparison of the benign and malignant lesions in respect of the need for repeated biopsies, the cases determined with malignancy were found to have a statistically significantly higher rate of repeated biopsy (p < 0.001). Conclusion: In comparison with cases of benign tumor, a statistically significantly greater number of repeated biopsies were required in cases diagnosed as malignant tumors to confirm the pathological diagnosis or when there was continued suspicion of malignancy. Therefore, when there is clinical suspicion, even if there are no findings of malignancy on the first biopsy, the biopsy should be repeated expeditiously.

Resumo Introdução: Em proporção direta à taxa crescente de exames de nasofaringe que são feitos, o diagnóstico precoce e o tratamento de lesões nessa região têm sido possíveis. Nem sempre os achados clínicos e os resultados da primeira biópsia são consistentes, levando à necessidade de biópsias repetidas. Objetivos: Avaliar a distribuição dos resultados dos testes histopatológicos obtidos pela biópsia de nasofaringe, determinar quais métodos foram mais frequentemente usados na identificação e investigar os casos nos quais a biópsia precisou ser repetida. Método: O estudo incluiu 1.074 pacientes (500 mulheres, 574 homens) submetidos a biópsia de nasofaringe em nossa clínica entre junho de 2011 e junho de 2017. Os dados foram obtidos dos prontuários dos pacientes e incluíram idade, sexo, achados clínicos, achados de imagem e diagnóstico histopatológico. Os diagnósticos histopatológicos foram separados em três grupos principais como nasofaringite crônica, citologia benigna e citologia maligna. Resultados: Os exames resultaram em 996 casos laudados como nasofaringite crônica, 47 como citologia benigna e 31 como citologia maligna. Das 31 lesões malignas, o diagnóstico foi feito em 15 (48,4%) com uma única biópsia e em 16 (51,6%), quando duas ou mais biópsias foram feitas. Na comparação das lesões benignas e malignas em relação à necessidade de biópsias repetidas, os casos determinados como malignos mostraram uma taxa estatisticamente maior de biópsia repetida (p < 0,001). Conclusão: Em comparação com os casos de tumores benignos, um número estatisticamente maior de biópsias repetidas foi necessário em casos diagnosticados como tumores malignos, para confirmação do diagnóstico histopatológico ou na suspeita continuada de malignidade. Portanto, quando há suspeita clínica, mesmo que não haja achados de malignidade na primeira biópsia, ela deve ser repetida tão logo seja possível.

Myoepithelial Carcinoma of Nasopharynx:Clinicopathologic Features and Relationship with Epstein-Barr Virus / 中山大学学报(医学科学版)

[Objective]To analyze the clinical and pathological characteristics of myoepithelial carcinoma of nasopharynx,as well as its relationship with Epstein-Barr virus.[Methods]We report twelve cases of myoepithelial carcinoma of nasopharynx,study its clinical,histopathologic,and immunohistologic features,follow-up data and EBERS in-situ hybridization.[Results]Among age of patients ranged from 24 to 65 years(mean age=46 years).Imagery data demonstrated an extensive nodosity filling the nasopharynx,Of these 12 cgses,myoepithelial markers such as S-100,SMA,P63,CK14,CK5/6 and epithelial markers such as CK,CKL,CKH were not always all expressed at one case,but at less one of these two kind of markers expressed at one cage.The results of EBERS in-situ hybridization of 12 cases were negative.[Conclusion]Myoepithelial carcinoma is a low malignat tumor.It seldom takes place in nasopharynx,dispite its morphologic heterogeneity it has some special morphologic and immuohistologic characteristics as well as special result of EBERS in-situ hybridization,which may support its diagnosis.The combinde radiotherapy and chemotherapy after surgical removal of the tumor will control the recurrence and metabasis effectively.

Biological characteristics of MMP and VEGF and their roles in theinfiltration and metastasis of nasopharynx carcinoma / 医学研究生学报

Researches have indicated that matrix metalloproteinases (MMP) and vascular endothelial growth factors (VEGF) play a key role in the metastasis of nasopharynx carcinoma (NPC). They promote tumor cell infiltration and metastasis by proteolysis of extracellular matrix proteolysis of tumor cells and induction of angiogenesis and lymphangioenesis. Researches on the mechanism of MMPs and VEGFs on NPC may help to further understand the metastasis of NPC and develop new methods for the diagnosis and treatment of NPC and other tumors as well.