title: Comparison of narrow-band imaging and conventional nasopharyngoscopy for the screening of unaffected members of families with nasopharyngeal carcinoma.
abstract: Familial aggregation of nasopharyngeal carcinoma (NPC) has been widely reported. The excess risk is about 4-8-fold among first-degree relatives of NPC patients compared with those without a family history of the disease. We used nasopharyngoscopy and a narrow-band image system (NBI) to screen NPC high-risk patients and identify a good tool for the early detection of NPC in these high-risk groups. We recruited all available, affected blood relations of the patients. When NPC patients were more distant relatives, such as cousins, we recruited their shared second-degree relatives, such as unaffected aunts and uncles, to genetically connect the NPC cases. We performed transnasal endoscopy, first in white-light mode, then under the NBI system. There were two NBI patterns in NPC: microvascular proliferation and engorged blood vessels. The NBI pattern in normal nasopharyngeal mucosa was a regular cobblestone pattern. A prospective study included 211 asymptomatic members from 154 NPC families. We found four cases of NPC, all with a tumor stage of T1. In one patient (1/4), MRI revealed a 2-cm-diameter neck lymphadenopathy (N1). The correlation between conventional nasopharyngoscopy and NBI was very high (κ = 0.798, P = 0.000). In conclusions, NBI is not superior to conventional nasopharyngoscopy for the early detection of NPC in unaffected members of families with NPC history. The long-term follow-up is necessary in high-risk NPC patients. Further studies will be needed to determine which screening tool-conventional nasopharyngoscopy, NBI, or EB virus titer-is most effective.
authors: Department of Otolaryngology, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, No. 201, Sec. 2, Shih-Pai Rd, Taipei 11217, Taiwan. cyho@vghtpe.gov.tw
authors: Ching-Yin
authors: CY
authors: Ho
authors: Kee-Tak
authors: KT
authors: Chan
authors: Pen-Yuan
authors: PY
authors: Chu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000473:pathology*; D042241:Early Diagnosis; D004724:Endoscopy / Q000379:methods*; D005190:Family; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging / Q000379:methods*; D059747:Nasal Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009303:Nasopharyngeal Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000235:genetics; D009305:Nasopharynx / Q000473:pathology*; D010865:Pilot Projects; D011446:Prospective Studies; D013624:Taiwan; D019562:Viral Load