The usefulness of cytodiagnosis and DNA cytometry on nasopharyngeal brush smears for the diagnosis of nasopharyngeal carcinoma

Chen, Maohuai; Chang, Alexander R.; Lo, Shikyuen

doi:10.1002/hed.10022

Cited by 4 publications

(4 citation statements)

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confidence: 60%

“…Lau et al used a silk swab stick to diagnose nasopharyngeal carcinomas and Lundgren et al used a wooden pin and a brush to diagnose laryngeal carcinomas. Adequacy of material, quality of staining and sampling dif¢culties were the major limiting factors, in agreement with Chen and coworkers [2].Fine needle aspiration cytology (FNA) has been shown to be a reliable and safe technique for the diagnosis of malignancy in the head and neck region. The FNA technique is particularly useful in this region because so many disparate entities may be considered in the differential diagnosis, but little data have been published on diagnosing tumors in the upper airways [9,14].…”

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confidence: 67%

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Cytology in Upper Respiratory Tract

Berner

2002

Ultrastructural Pathology

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Respiratory tract cytology is well recognized and widely accepted as the initial step in the diagnosis of respiratory tumors. In particular, bronchial and lung tumors are diagnosed by cytologic examination of either exfoliated cells in sputum or bronchial brush and lavage specimens. Lesions in the upper respiratory tract, including the nasal cavities, mouth, pharynx and larynx, can also be diagnosed using cytology. However, tumors are rare events in the upper airways and relatively few studies have been published [2, 3, 6, 10, 12¡15]. The ¢rst report of cytologic evaluation of exfoliated oral and pharyngeal epithelial cells was published by Beale in 1860. Other authors have since contributed to cytologic examination of the upper respiratory tract. The advantage of cytology is that the collection of cells is simple and usually harmless to the patient and potentially malignant cells, which have lost their cohesiveness to adjacent tissues, are preferentially sampled.Early detection of tumors is crucial for patient survival and false negative results are of particularly great concern. In cervical cytology it is widely acknowledged that up to two thirds of the overall false-negative rates can be attributed to sampling errors. Sampling errors represent a failure to harvest and present diagnostic cells.Nasopharyngeal scrape and brush cytology has been employed to detect both benign and malignant conditions [6,7,10,15].The present article by Merigo and coworkers [7] in this issue of Ultrastructural Pathology presents electron microscopic examination of nasal mucosa from asthmatic children as an ancillary diagnostic method. The specimens were collected by brush cytology and the authors conclude that this minimal invasive test detects mucosal changes that could be related to allergy. Complications related to bronchoscopy were avoided. Granados and coworkers [6] similarly used nasal scrape cytology to diagnose Wegeners granulomatosis, whereas Voss and coworkers [15] identi¢ed precancerous lesions in nasal mucosa of individuals with occupational exposure to nickel and wood. They concluded that brushing and scraping method enables one to collect cells from a larger area than the one sampled by biopsy, thereby yielding more diagnostic material.In two prospective studies by Lau and coworkers [10] and Lundgren and coworkers [12] the diagnostic sensitivity of cytologic examination in diagnosing histologically malignant tumors was 71% and 83%, respectively. Lau et al. used a silk swab stick to diagnose nasopharyngeal carcinomas and Lundgren et al. used a wooden pin and a brush to diagnose laryngeal carcinomas. Adequacy of material, quality of staining and sampling dif¢culties were the major limiting factors, in agreement with Chen and coworkers [2].Fine needle aspiration cytology (FNA) has been shown to be a reliable and safe technique for the diagnosis of malignancy in the head and neck region. The FNA technique is particularly useful in this region because so many disparate entities may be considered in the differential diagnos...

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confidence: 60%

mentioning

confidence: 67%

Cytology in Upper Respiratory Tract

Berner

2002

Ultrastructural Pathology

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“…11 Monitoring of EBV parameters reflecting increased viral burden and carcinoma-specific transcriptional activity is more sensitive and specific than previously described cytological evaluation of NP brushing smears (Refs. 43,44 ; Harijadi et al, unpublished data).…”

Section: Np Brushings Of Npc Patients Contain Extremely High Ebv Dna mentioning

confidence: 98%

Noninvasive diagnosis of nasopharyngeal carcinoma: Nasopharyngeal brushings reveal high Epstein‐Barr virus DNA load and carcinoma‐specific viral BARF1 mRNA

Stevens

Verkuijlen

Hariwiyanto

et al. 2006

Intl Journal of Cancer

107

130

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Nasopharyngeal carcinoma (NPC) is the most prevalent ENTtumour in Indonesia. We investigated the primary diagnostic value of Epstein-Barr virus (EBV) DNA load and mRNA detection in noninvasive nasopharyngeal (NP) brushings, obtained prospectively from consecutive Indonesian ENT-patients with suspected NPC (N 5 106) and controls. A subsequent routine NP biopsy was taken for pathological examination and EBER-RISH, yielding 85 confirmed NPC and 21 non-NPC tumour patients. EBV DNA and human DNA load were quantified by real-time PCR. NP brushings from NPC patients contained extremely high EBV DNA loads compared to the 88 non-NPC controls (p < 0.0001). Using mean EBV DNA load in controls plus 3 SD as cut-off value, specificity, sensitivity, positive and negative predictive values were 98, 90, 97 and 91%, respectively. Epstein-Barr nuclear antigen 1 (EBNA1) and the carcinoma-specific BARF1 mRNA were detected by nucleic acid sequence based amplification and found in 86 and 74% of NP brushings, confirming NPC tumour cell presence. EBV RNA positivity was even higher in fresh samples stored at 280°C until RNA expression analyses (88% for both EBNA1 and BARF1). EBV RNA-negative NP brushings from proven NPC cases had the lowest EBV DNA loads, indicating erroneous sampling. No EBV mRNA was detected in NP brushings from healthy donors and non-NPC patients. In conclusion, EBV DNA load measurement combined with detection of BARF1 mRNA in simple NP brushings allows noninvasive NPC diagnosis. It reflects carcinoma-specific EBV involvement at the anatomical site of tumour development and reduces the need for invasive biopsies. This procedure may be useful for confirmatory diagnosis in large serological NPC screening programs and has potential as prognostic tool. ' 2006 Wiley-Liss, Inc.Key words: EBV; NPC; diagnosis; viral load; oncogene; carcinoma Undifferentiated nasopharyngeal carcinoma (NPC WHO type III) is virtually 100% associated with Epstein-Barr virus (EBV) and has a reported high incidence in most of South-East Asia and intermediate incidence in North-African populations and in Inuit. [1][2][3] In Indonesia, with an ethnically diverse population of 225 million people, NPC is the most common ENT tumour with high prevalence among native populations and a yearly overall incidence estimated at 6.2/100,000. 4 Extremely high incidence was recently documented in native populations living on the island of Sulawesi. 5 In Yogyakarta, Central Java, NPC is the most prevalent tumour among man and 4th most prevalent among females, with a male/female ratio of 2.4, constituting respectively 22 and 8% of all diagnosed malignancies. 4 The strong etiological link between EBV and NPC has been known for over 3 decades [1][2][3]6 and is reflected by abnormal anti-EBV antibody profiles, increased circulating EBV DNA levels and by distinct EBV gene expression in the tumour cells. 7-11 Classically, NPC is considered to have a latency type 2 EBV transcription, with expression of EBV-encoded small RNAs 1 and 2 (EBER1/2), BamHI A rightward transcript...

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“…The palatine veil rises suddenly when the individual starts breathing through his/her mouth. The process of heating, humidifying and purifying the inhaled air is completed in the rhinopharynx, a process that has started in the nostrils [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Study on the Rhinopharynx Neoplasms

CĂLIN¹,

ZAHARESCU²,

PALIVAN³

2021

MedMater

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In order to receive the food bolus, the muscular-fibrous walls of the pharynx contract by reflex, first widening the pharynx, and the palatine veil rises, closing the passage to the rhinopharynx. Then the base of the tongue rises, the piers approach, closing the bucco-pharyngeal passage in the isthmus. The airway is simultaneously interrupted by the posterior displacement of the base of the tongue, the folding of the mucosa of the posterior pharynx, and the lifting and closing of the larynx. The food bolus is thus forced to follow the hypopharyngeal-esophageal pathway, the only one that remains open. In case of paralysis of the nerves that coordinate the swallowing process, the laryngeal sphincter remains open, favoring the false pathway and aspiration bronchopneumonias. The paralysis of the palatine veil prevents its horizontalization during swallowing, which favors the discharge of fluids into the nose, which is significant when the paralysis is bilateral and more discrete when it is unilateral. The clinical prospective and retrospective study material was represented by a number of 190 individuals aged 0 to 80 years, who were hospitalized between 01.01.2011 and 31.12.2019 in the ENT Department of the Teaching Hospital in Galați for follow-up of malignant rhinopharyngeal tumors. Most of these patients subsequently underwent sequential examination to determine their treatment response. Due to its deep location and limited clinical accessibility, onset symptoms are often absent or inconclusive for both the physician and the patient. CT scan is superior to clinical examination in primary tumor evaluation, especially in advanced T3 and T4 cases, which are largely clinically under-rated. Performing the coronal rhinopharynx sections and double-window recording greatly increase the accuracy of examination and they should be considered at least for the initial assessment procedure.

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The usefulness of cytodiagnosis and DNA cytometry on nasopharyngeal brush smears for the diagnosis of nasopharyngeal carcinoma

Cited by 4 publications

References 10 publications

Cytology in Upper Respiratory Tract

Cytology in Upper Respiratory Tract

Noninvasive diagnosis of nasopharyngeal carcinoma: Nasopharyngeal brushings reveal high Epstein‐Barr virus DNA load and carcinoma‐specific viral BARF1 mRNA

Study on the Rhinopharynx Neoplasms

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