上咽頭癌における Epstein-Barr virus 関連の有無と予後因子  [in Japanese] Prognostic Factors in Patients with Nasopharyngeal Carcinoma  [in Japanese]

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Author(s)

    • 小幡 和史 Obata Kazufumi
    • がん研究会有明病院頭頸科|札幌医科大学付属病院耳鼻咽喉科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)|Department of Otolaryngology Sapporo Medical University
    • 蛯名 彩 Ebina Aya
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 神山 亮介 Kamiyama Ryosuke
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 日高 竜太 Hidaka Ryuta
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 近藤 貴仁 Kondo Takahito
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 上里 迅 Uezato Jin
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 服部 雅優 Hattori Masakatsu
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 米川 博之 Yonekawa Hiroyuki
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 佐藤 由紀子 Sato Yukiko
    • がん研究会有明病院がん研究所病理部 Department of Pathology, Cancer Institute of the Japanese Foundation For Cancer Research (JFCR)
    • 川端 一嘉 Kawabata Kazuyoshi
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 三谷 浩樹 Mitani Hiroki
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 福島 啓文 Fukushima Hirofumi
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 佐々木 徹 Sasaki Tohru
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 新橋 渉 Shimbashi Wataru
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)
    • 瀬戸 陽 Seto Akira
    • がん研究会有明病院頭頸科 Division of Head and Neck Surgery, Cancer Institute Hospitalof the Japanese Foundation For Cancer Research (JFCR)

Abstract

<p> 背景 : EBER (Epstein-Barr virus encoded small RNA) 陽性上咽頭癌は予後良好と報告されているが, EBER が上咽頭癌の予後に如何に関与するかは不明である. </p><p> 方法 : 2005~2012年でがん研有明病院にて一次治療を行い, EBER を測定した上咽頭癌45例を対象に後向き解析を行った. 年齢, 性別, T・N 分類, 病期・病理分類, 亜部位, EBER 陽・陰性, シスプラチン投与量を対象とし, 全生存期間と無増悪生存期間, 独立した予後因子を求めた. また, 有害事象, 各因子間の相関, 死亡症例を解析した.</p><p> 結果 : 5年全生存率, 無増悪生存率は76.9%, 63.2%であった. 単変量解析では, 全生存期間・無増悪生存期間において EBER, 病理・病期分類で有意差を認めた. 全生存期間では病理分類, 無増悪生存期間では病理・病期分類が独立した予後因子であり, EBER と病理分類に相関を認めたが, 治療後遠隔転移発生と相関する因子は認めなかった. 死亡症例では WHO type II・III が遠隔転移, WHO type I は原発・頸部転移が多く見られた.</p><p> 結論 : EBER の陽・陰性は独立した予後因子とはならず, EBV 関連の有無は病理組織学的分類ほどの予後予測因子ではないこと, 独立した予後因子である病理組織型と EBV 感染の関連性が示唆された.</p>

<p>  Background: The prognosis of Epstein-Barr virus-encoded small RNA (EBER)-positive nasopharyngeal carcinoma (NPC) is reportedly good, however, how EBER affects the prognosis of NPC remains unclear.</p><p> Methods: We retrospectively analyzed the clinical outcomes and prognostic factors in patients with NPC who received the initial treatment at the Cancer Institute Hospital between 2005 and 2012. We examined the overall survival, progression-free survival and independent prognostic factors such as the age, sex, TNM classification, stage, pathological findings, tumor site and presence/absence of EBER among 50 patients with NPC. We also evaluated the correlations between the presence/absence of EBER and the pathological findings of NPC/the disease-related mortality.</p><p>  Results: The five-year overall and progression-free survival rates were 76.0% and 61.4%, respectively. Univariate analysis revealed significant differences in the overall survival, EBER, pathological findings, M classification and stage classification. Significant differences were also noted in the progression-free survival, prevalence of EBER, pathological findings, N and M classification and stage classification. Multivariate analysis identified pathological findings and stage classification as independent prognostic factors for the overall and progression-free survival. We also found a correlation between the presence/absence of EBER and the pathological findings.</p><p> In the case of WHO type II and III NPC, the site of the tumor at the time of death was often distant metastasis. On the other hand, in the case of WHO type I, primary carcinoma and neck lymph node metastases were predominant.</p><p> Conclusion: Pathological findings and stage classification were identified as independent prognostic factors for the overall survival and progression-free survival in patients with NPC. Presence/absence of EBER was not an independent prognostic factor for NPC, but could affect the prognosis after treatment is administered. These factors are important for planning the treatment and subsequent follow-up of NPC.</p>

Journal

  • Nippon Jibiinkoka Gakkai Kaiho

    Nippon Jibiinkoka Gakkai Kaiho 120(11), 1318-1327, 2017

    The Oto-Rhino-Laryngological Society of Japan, Inc.

Codes

  • NII Article ID (NAID)
    130006251041
  • NII NACSIS-CAT ID (NCID)
    AN00191551
  • Text Lang
    JPN
  • ISSN
    0030-6622
  • NDL Article ID
    028684218
  • NDL Call No.
    Z19-250
  • Data Source
    NDL  J-STAGE 
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