Familial Nasopharyngeal Carcinoma 6

Screening and Early Diagnosis of Nasopharyngeal 5CarcinomaPei-Jen Lou, Wan-Lun Hsu, Yin-Chu Chien, and Chien-Jen ChenCONTENTS5.1 Introduction 535.2 Potential Advantage of EarlyDiagnosis 545.3 Screening of NPC by Epstien–BarrVirus Seromarkers 545.3.1 Anti-EBV Antibodies for the EarlyDetection and Prognostic Predictionof NPC 545.3.2 Discovery of Circulating EBV DNAand mRNA in NPC Patients 555.3.3 Case-Control Studies on NPCand Anti-EBV Seromarkers 555.3.4 Case-Control Studies on NPCand EBV DNA in Serum 565.3.5 Cohort Studies on NPC and Anti-EBVSeromarkers 565.3.6 Sensitivity and Specificity of EBVSeromarkers for NPC Screening 565.4 Screening for Family Membersof Patients with NPC 575.5 Clinical Methods for Screeningand Early Diagnosis of NPC 575.5.1 Early Symptoms 605.5.2 Nasopharyngeal Examination 605.5.3 Nasopharyngeal Swab for EBV DNAin the Screening of NPC 615.6 Summary 61References 62Pei-Jen Lou, MD, PhDDepartment of Otolaryngology, College of Medicine, NationalTaiwan University, Taipei 100, Taiwan, ROCWan-Lun Hsu, PhDYin-Chu Chien, PhDChien-Jen Chen, ScDGenomics Research Center, Academia Sinica, Academia RoadSection 2, Nankang, Taipei 115, Taiwan, ROC5.1IntroductionNasopharyngeal carcinoma (NPC) is a relatively raredisease in most parts of the world, but is the most commonlydiagnosed head and neck cancer in certainregions of Southeast Asia. The age-standardized incidencerate is less than 1 per 100,000 persons per year foreither gender worldwide, while the annual incidence insouthern China and Southeast Asia approaches 20 per100,000 persons. In most populations, the age-standardizedannual incidence rate of NPC is higher in malesthan in females. The male-to-female ratio is around2–3:1 in high- and moderate-risk areas. Although it hasbeen reported in NPC patients ranging from 4 to 91years of age in various countries, it is uncommon underthe age of 20 years (