Early detection of nasopharyngeal cancer

May 31st, 2011 by admin Leave a reply »

In Indonesia, nasopharyngeal cancer is the most malignant tumors in ENT and is ranked the 5th largest for malignant tumors throughout the body with high mortality rates. The etiology of nasopharyngeal cancer is not known with certainty, allegedly associated with Ebstein Barr virus.
IN cases of nasopharyngeal cancer, the highest incidence found in ethnic Mongoloid. The disease can be of all age groups, the highest in decades 4 and 5. In endemic areas, 60% of patients aged less than 50 years. Comparison of male and female 2:1 to 4:1. At this age they are generally productive, so we need maximum effort to reduce this high mortality rate that is by doing nasopharyngeal cancer diagnosis as early as possible or at an early stage. Early diagnosis will determine the prognosis of the patient or the 5-year survival rate.
Diagnosis of nasopharyngeal cancer are often done too late. This is due dininya atypical symptoms and the hidden location of the nasopharynx. He was hidden behind the nasal cavity and located below the base of the head and associated with many important areas in the brain and neck. Patients are often only came for a treatment after the symptoms appear due to the spread of the tumor as a lump in the neck or neurological disorders. Given the location of the nasopharynx are not easily checked, the patient should consult an expert on them so the diagnosis can be established as early as possible.
Many factors are thought to relate to the incidence of malignant nasopharyngeal tumors, although the exact etiology is unknown. There are allegations of factors that play a role in it is the Epstein Bar virus infection, genetic susceptibility (Mongoloid race) and the environment, including living habits. Neighborhood factors and lifestyle habits, such as wood smoke used for cooking, often in contact with substances that can cause cancer or substances such karsiogenik bensophyrene, chemical gases, smoke, plant, insect repellent smoke, cigarette smoke, nitrosamines found in salted fish.
Symptoms Varies
Early symptoms of nasopharyngeal cancer is highly variable and are not typical symptoms of influenza as usual. Complaints that arise depending on the position and the extension of nasopharyngeal tumors, whether grown to estuary fallopian eustachius from ear or nose. Complaints that occur in the ear or nose was unilateral or one sided. Generally, ear disorders appear as early symptoms because tumors originated in the vicinity of the mouth of the fallopian eustachius called rossenmuller fossa tumor where the growth will clog the mouth of the tube. Disorders of the ear, can be a feeling of fullness in the ear, hearing loss, ear buzzing and pain in the ear.
Complaints of nasal obstruction in the form of settled on one side or both nostrils and recurrent bleeding (nosebleeds) or nasal mucus mixed with blood which caused the wall surface of tumor fragile, so easy to bleed in mild irritation. Another complaint form can not smell the smell and nose.
Symptoms that appear on the ears and nose is not a typical symptom of nasopharyngeal cancer, because it is also found in the form of infectious ENT diseases which are already widely known among other middle ear infections, chronic colds, sinusitis and others. Patients often regard this as something that is not dangerous because they do not immediately see a doctor. Instead the patient had gone to the doctor but the doctors diagnose as a chronic runny nose, runny nose usual. But if it is unilateral – occur repeatedly or settled without obvious cause, vigilance against the possibility of nasopharyngeal cancer should be improved especially with a lump in the upper neck.
In addition to symptoms of ear and nose, headache symptoms were also found in early cases. In nasopharyngeal cancer diagnosis needs to be done a series of examination and diagnosis must be confirmed by nasopharyngeal biopsy.
Examination of rinoskopi posterior nasopharynx using a mirror or with endoscopy. In many ways, endoscope 90% more profitable because it can see the nasopharynx at an early stage to assess the formation of a mild elevation of asymmetry. Because of its uses is to examine more thoroughly the nasopharynx and more detailed, the tool is very useful in early detection of mucosal layer in endemic areas and working in the early detection of a recurrence.
Nasopharyngeal biopsy can be performed with local anesthesia or general anesthesia. A biopsy should be done”avoe.”Furthermore, to ensure nasopharyngeal cancer biopsy tissue pathology examination by an anatomical pathologist.
Then, the current serological introduced as one way for early detection of nasopharyngeal cancer. With the entry of viruses into human cells, the body will form an immunological or immune reaction against antigens in the virus. The investigation of immunological reaction against Epstein Barr virus antigen has been successfully identified several specific antigens found in nasopharyngeal carcinoma.
1. Antibodies Ig G and Ig A against Viral Capsid Antigen (VCA). Until recently, the examination titer Ig A – VCA is considered the most specific and sensitive for early diagnosis of nasopharyngeal cancer. This test is also considered the method of choice for the state primary occolt namely the discovery of abnormal condition of the cervical gland enlargement or destruction of the skull base or brain nerve paralysis in the absence of tumor in the nasopharynx.
2. Ig G anti Farly Antigen (FA). For early detection of nasopharyngeal cancer, this test is less sensitive when compared with Ig A – VCA.
3. Antibody Dependent Cellular Cytotoxicty (ADCC). ADCC examination to determine the course of the disease and prognosis based on the high and low titer at the time of diagnosis.
As a means of early diagnosis, test A-VCA Ig is the most sensitive test for early detection of nasopharyngeal cancer, but it is advisable to do combinations with Ig G – EA to make it more specific and sensitive. For definite diagnosis of nasopharyngeal cancer, it remains to be done a biopsy and pathological-anatomical examination, whereas serologic as one of nasopharyngeal cancer early detection guidelines.


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