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History Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Plan a flexible nasendoscopy to rule out a nasopharyngeal cancer. These can involve any of the cranial nerves. By this stage in progression it is very likely that other, lower cranial nerves will also be compromised.
Genetic testing for personalised medicine and limitations of the current medical practise in public health
Published in Ben Y.F. Fong, Martin C.S. Wong, The Routledge Handbook of Public Health and the Community, 2021
Many diseases are caused by infectious microorganisms, such as Epstein-Barr Virus (EBV) which has a high correlation with the development of nasopharyngeal cancer (Hau et al., 2020), while Helicobacter pylori has been proven a causative agent of stomach ulcer and cancer (Choi et al., 2020). Hence, early detection of these microorganisms in human body leading to early treatment of these diseases can, very often, improve the medical outcome. A study has shown that sequencing of the DNA in human serum allows detection of viral DNA, such as EBV, which can be used as a screening test for nasopharyngeal cancer in the general population (Lam et al., 2018). In the future, it is possible to identify tens of thousands of microorganisms in blood in a single sequencing screening. Thanks to the exponential growth in the development of the sequencing technology, the cost of a whole genome sequencing has been dramatically reduced to approximately US$7000–10,000 (Bick et al., 2017). As this reliable technology becomes more affordable, it is anticipated that WGS will become more accessible to patients in the future.
Inflammatory Disorders of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
In marked contrast to the high incidence of benign tumors causing chiasmal compression: Nasopharyngeal cancer.Metastases.Lymphoma.Pituitary adenoma.
Incidence of head and neck cancer among first-generation immigrants and their children in Finland
Published in Acta Oncologica, 2023
Rayan Mroueh, Elli Hirvonen, Janne Pitkäniemi, Nea Malila, Jaana Hagström, Antti Mäkitie, Anni Virtanen
It appears that select immigrant groups retain similar incidence rates as seen among natives of their region of origin. Cultural transmission of exogenous exposures may, at least partially, explain the increased risk among these populations. An increased risk of nasopharyngeal cancer (NPC) has been previously described among Asian and North African immigrants in Sweden [14], France [15], and Israel [9]. Although the etiology of NPC is multifactorial [16], Epstein–Barr virus (EBV), along with genetic predisposition, is regarded as playing a predominant role in the etiology of NPC through its oncogenic effect [17,18]. Regarding HPV, its association with oropharyngeal cancer is well documented, and some evidence, albeit weak, also implies a possible link with laryngeal cancer [19]. A meta-analysis revealed a prevalence of 49% (95% CI: 35–64%) of any type of HPV and 35% (95% CI: 26–45%) of high-risk HPV in men [20]. Conversely, in the Middle East, Southeast Asia, and East Asia, reported prevalence rates of HPV do not exceed 10% [21]. The prevalence differences parallel the high incidence of pharyngeal cancer among European immigrants in our study.
The value of serum p53 antibody as a biomarker in oral and pharyngeal squamous cell carcinoma
Published in Acta Oto-Laryngologica, 2023
Shotaro Hirokawa, Koji Araki, Taku Yamashita, Kosuke Uno, Masayuki Tomifuji, Hideaki Shimada, Akihiro Shiotani
The carcinogenic mechanism of p16-positive oropharyngeal cancer is characterized by deregulated human papillomavirus (HPV) E6 and E7 oncoprotein expression in proliferating cells [16]. E6 and E7 inactivate p53 and RB, respectively, resulting in the disruption of cell cycle regulation and inhibition of p53‑mediated apoptotic responses, driving immortalization, and the accumulation of epigenetic and genetic alterations necessary for cancer progression. Nasopharyngeal cancer is caused by the Epstein-Barr virus (EBV), which is a persistent infection of the pharyngeal mucosa. EBV-encoded proteins, including latent membrane protein 1 (LMP1), LMP2A, and EBV nuclear antigen 1 cause dysregulation of intracellular signaling pathways in nasopharyngeal cancer cells [17]. These facts indicate that the oncogenic mechanism of virus-related cancer is independent of p53 gene mutations, and it is also related to the small number of TP53 mutations shown in HPV-related cancers in the TCGA study [14]. Therefore, autoantibodies against mutant p53 protein are not produced in patients with virus-related pharyngeal cancer, and our results support this.
The global, regional, and national burden of nasopharyngeal carcinoma and its attributable risk factors in 204 countries and territories, 1990–2019
Published in Acta Oto-Laryngologica, 2022
Yuna Zhang, Yujie Cao, Lin Luo, Jun Li, Liuqian Wang, Yaqin Lu, Shanshan Gu, Hongxia Deng, Zhisen Shen
Nasopharyngeal carcinoma (NPC) is uncommon in most areas of the world but poses a significant public health burden in endemic regions [1]. Nasopharyngeal carcinoma is a common malignant tumor in southern China and Southeast Asian countries, with an incidence of 10–50/100,000 [2]. Due to the hidden location of nasopharyngeal cancer, most patients have developed to advanced stage when they are diagnosed. Studies have confirmed that the survival of early stage patients is significantly better than that of late stage patients, so the early diagnosis of nasopharyngeal carcinoma is of great significance. Several studies have shown that the titers of EB virus-related antibodies NA1/IgA and VCA/IgA in patients with nasopharyngeal carcinoma are increased [1], and these antibodies have been widely used in the early diagnosis and screening of nasopharyngeal carcinoma.