Nasopharyngeal carcinoma in Ibadan, Nigeria: a clinicopathologic study.

INTRODUCTION: nasopharyngeal carcinoma is relatively common in our environment. It is one of the most difficult malignancies to diagnose at an early stage. The aim of the study was to determine the clinical features, clinical disease stage of nasopharyngeal carcinoma at presentation and at diagnosis as well as the histologic types at the University College Hospital, Ibadan, Nigeria. METHODS: this was a ten year retrospective study of all histologically confirmed nasopharyngeal carcinoma between January 2007 to December 2016 using clinical and pathology records and files. RESULTS: there were 73 cases. The male: female ratio was 1.7. The age of patients ranged from 12 to 80 years with a mean age of 39 ± 16 years. The median age at diagnosis was 40 years. The peak age group of occurrence was 40-49 years. The most common symptoms were namely epistaxis in 67.1% of patients at presentation, neck mass/swelling (64.4%) and nasal mass/obstruction (63.0%). Majority (54.8%) of the patients presented late with stage 3 or 4 disease. Most (94.5%) of the tumours were of the non-keratinizing squamous cell carcinoma subtype. The keratinizing and basaloid variants accounted for 4.1% and 1.4% of the tumours respectively. CONCLUSION: vague, non-specific symptoms make patients present at late stages of the disease, making it almost impossible to attempt cure. The dominant histopathological type is non-keratinizing squamous cell carcinoma and resembles that seen in most parts of Nigeria and endemic areas of the world.

Serum levels of single-carbon metabolism vitamins and homocysteine in head-and-neck squamous cell carcinoma: Preliminary report.

Background: Head-and-neck carcinomas are a heterogeneous group of malignancies arising from the upper aerodigestive tract. Tobacco and alcohol are the leading etiological factors; however, bioactive food components, including those that modulate DNA methylation, are being linked to susceptibility. This work assesses the distribution of head-and-neck cancers presenting at a tertiary health institution and determined the serum level of the vitamins and an amino acid involved in the methionine cycle, in view of increasing acceptance of the significant role of DNA methylation in the pathogenesis of cancers. Patients and Methods: This study involved 30 newly diagnosed cases of head-and-neck squamous cell carcinoma. Thirty apparently healthy volunteers served as controls. The test cases were made up of 19 males and 11 females while controls were made up of 14 males and 16 females. The median ages of the test cases and controls were 59 and 63 years, respectively. Sera obtained from participants' blood were analyzed by high-performance liquid chromatography technique. The study protocol was approved by the joint University of Ibadan/University College Hospital Institution Review Board. Results: There is a male dominance in the number of cases at male-to-female ratio of 1.7: 1. The oral cavity was the most-affected site. Serum levels of Vitamin B2, B6, B12, and homocysteine were lower in cases compared with controls but not significantly so. However, serum Vitamin A and folic acid levels were significantly lower among the cases ([0.62 vs. 0.71, z = -2.50, P = 0.02], [26.05 vs. 30.82, z = 0.20, P = 0.00]) compared with controls. Only tobacco and alcohol use showed a significant association with head-and-neck cancer, but not family history of cancer or alcohol use alone (P = 0.00). Conclusion: Significantly low serum Vitamin A and hypofolataemia are associated with head-and-neck squamous cell carcinoma. This is suggestive of a role for these vitamins in the etiopathogenesis of the disease.

RésuméContexte: Les carcinomes de la tête et du cou sont un groupe hétérogène de tumeurs malignes provenant du tractus aérodigestif supérieur. Le tabac et l'alcool sont les principaux facteurs étiologiques ; cependant, les composants alimentaires bioactifs, y compris ceux qui modulent la méthylation de l'ADN, sont liés à la susceptibilité. Ce travail évalue la répartition des cancers de la tête et du cou présentant a une institution de santé tertiaire et a déterminé le niveau sérique des vitamines et un aminoacide impliqués dans le cycle de la méthionine, au vu de la croissante acceptation et du rôle signifiant la méthylation de l'ADN dans la pathogenèse des cancers. Patients et méthodes: Cette étude portait sur 30 cas nouvellement diagnostiqués de carcinome épidermoïde de la tête et du cou. Trente volontaires apparemment en bonne santé ont servi de contrôles. Les sujets testés étaient composés de 19 hommes et de 11 femmes, tandis que les témoins étaient composés de 14 hommes et de 16 femmes. L'âge médian des cas tests et des témoins était de 59 et 63 ans, respectivement. Les sérums obtenus à partir du sang des participants ont été analysés par la technique de chromatographie liquide à haute performance. L'étude a été approuvée par le comité mixte de revue des institutions de l'Université d'Ibadan/Collège Hospitalier Universitaire. Résultats: Il y a une dominance masculine dans le nombre de cas avec un ratio homme-femme de 1,7 : 1. La cavité orale était le site le plus touché. Les taux sériques de vitamine B2, B6, B12et d'homocystéine étaient plus bas parmi les cas par rapport aux témoins mais pas de manière significative. Néanmoins, les niveaux sériques de vitamine A et d'acide folique étaient plus bas parmi les cas ([0,62 vs 0,71 ; z = -2.02 ; P = 0,02], [26,5 vs 30,82 ; z = 0,20 ; P = 0,00]) par rapport aux témoins. Seule l'usage du tabac et d'alcool a montré une association significative avec le cancer de la tête et du cou, mais pas les antécédents familiaux de cancer ou la consommation d'alcool seul (P = 0,00). Conclusion: Les niveaux sériques significativement bas de vitamine A et d'hypovolémie sont associés au carcinome épidermoïde de la tête et du cou. Ceci suggère un rôle pour ces vitamines dans l'étiopathogenèse de la maladie.