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Comparison of narrow-band imaging and conventional nasopharyngoscopy for the screening of unaffected members of families with nasopharyngeal carcinoma

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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.

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Acknowledgments

Funding Support by V100C-038 from Taipei Veterans General Hospital and NSC 98-2314-B-075-016-MY3.

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  1. 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

    Ching-Yin Ho, Kee-Tak Chan & Pen-Yuan Chu

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  1. Ching-Yin Ho
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Correspondence to Ching-Yin Ho.

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Ho, CY., Chan, KT. & Chu, PY. Comparison of narrow-band imaging and conventional nasopharyngoscopy for the screening of unaffected members of families with nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol 270, 2515–2520 (2013). https://doi.org/10.1007/s00405-013-2354-y

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  • DOI: https://doi.org/10.1007/s00405-013-2354-y

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