ABSTRACT
CONCLUSION: Advanced parapharyngeal space (PPS) involvement showed stronger prognostic value than PPS involvement. The classification of PPS involvement proposed by Min or Sham was the most appropriate classification for parapharyngeal extension in nasopharyngeal carcinoma (NPC). The degree of tumor extension into the PPS should be considered in future TNM staging revisions. OBJECTIVES: This study was conducted to evaluate the prognostic significance of the various classifications for PPS involvement in patients with NPC. METHODS: From January to July 2000, a total of 176 patients with pathologically diagnosed NPC were prospectively enrolled in this study. The extent of PPS involvement was examined by contrast-enhanced computed tomography (CT) scan and graded according to the four previously reported classifications (Min, Sham, Xiao, and Heng). RESULTS: The incidence of PPS involvement was 81.8%. The 5-year overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and local relapse-free survival rates (LRFS) of the patients with and without PPS involvement were 68.1% and 90.2% (p = 0.010), 66.1% and 87.2% (p = 0.013), 76.7% and 93.6% (p = 0.032), and 84.9% and 93.1% (p = 0.220), respectively. Multivariate analysis showed that PPS involvement (yes vs no) was not an independent prognostic factor. However, graded PPS involvement was an independent factor affecting the prognosis of NPC. When the four classifications were included in a Cox model, it was shown that PPS involvement based on Min's classification was an independent factor for OS (p = 0.001). PPS involvement based on Sham's classification was an independent factor for PFS (p = 0.010) and DMFS (p = 0.009).
Subject(s)
Carcinoma/pathology , Nasopharyngeal Neoplasms/pathology , Pharynx/pathology , Adolescent , Adult , Aged , Carcinoma/classification , Disease Progression , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Nasopharyngeal Carcinoma , Nasopharyngeal Neoplasms/classification , Neoplasm Grading , Neoplasm Staging , Prognosis , Prospective Studies , Young AdultABSTRACT
BACKGROUND & OBJECTIVE: P53 and proliferating cell nuclear antigen(PCNA) relate with tumorigenesis, development, and prognosis of malignant tumors. This study was to detect expression of P53 and PCNA in nasopharyngeal carcinoma (NPC) tissue, and discuss their relation of p53 and PCNA expression with clinical stage, VCA/IgA, EA/IgA, radiation sensibility, and prognosis. METHODS: Immunohistochemistry was used to detect P53 and PCNA expression in NPC tissue of 80 patients received radiotherapy alone. Relation of P53 and PCNA expression with clinical stage, VCA/IgA, EA/IgA, extinction of nasopharygeal tumor and neck lymph node when radiation dose was 36 Gy, and 5-year survival rate was analyzed by Chi-square test. RESULTS: Positive rate of P53 in NPC tissues was 92.5%, and that of PCNA was 100%. Expression intensity of PCNA significantly related with extinction of nasopharygeal tumor, and neck lymph node when radiation dose was 36 Gy, but P53 had no significant relation with it. Expression intensities of P53 and PCNA had no significant relation with NPC clinical stage, VCA/IgA, EA/IgA, and 5-year survival rate. CONCLUSIONS: P53 and PCNA relate with NPC occurrence. PCNA relates with NPC radiation sensibility, but P53 doesn't. P53 and PCNA have no relation with NPC clinical stage, VCA/IgA, EA/IgA, and prognosis.
