The Difference Of Clinical Manifestations And Prognosis In Different Pathological Types Of Nasopharyngeal Carcinoma

Objective:To investigate the difference between various pathological types of NPCinclude the patients’ gender, T stage, N stage, recurrence, metastasis and the positiverate of serum EBV-IgA, then further explore the relationship with survival rate, andanalysis the other factors which related to the NPC patients’ prognosis.Methods:Clinical data of1286NPC patients received treatment in Fuzhou generalhospital of Nanjing military command from Jan1,2006to Sep1,2012were studiedretrospectively, this data including pathological types, results of serum EBV-IgA, age,T stage, N stage, treatment methods, recurrence and metastasis, and followed thepatients’ survival condition. X2test was used to observe the difference betweenvarious pathological types of NPC include patients’ gender, T stage, N stage,recurrence, metastasis and the positive rate of serum EBV-IgA, Kaplan-Meier wasused to survival analysis and Log-Rank was used to test the difference of survival ratein the study groups, respectively. In addition, we used Cox regression mode formultiple factors analysis.Results:1. Included in the study of1286cases of nasopharyngeal carcinoma, WHO-Ⅰhave76cases of nasopharyngeal carcinoma, WHO-Ⅱ/Ⅲthere are1210cases of type2. There was statistical difference between type WHO-Ⅰ and type WHO-Ⅱ/Ⅲ（P=0.015）in T stage,3. the antibody positive rate of type WHO-Ⅰand type WHO-Ⅱ/Ⅲwere74.5%and85.4%with a statistical difference（P=0.036）.4. WHO-Ⅰtype77.6%(59/76) had lymph node metastasis, and WHO-Ⅱ/Ⅲtype87.0%(1057/1210) had lymph node metastasis, the difference was statisticallysignificant differences (P=0.015). 5. there was no difference between type WHO-Ⅰ and type WHO-Ⅱ/Ⅲ ingender, N stage, recurrence, metastasis（P＞0.05）.6. The NPC patients’1,3and5years overall survival rates of type WHO-Ⅰ andtype WHO-Ⅱ/Ⅲ were84%、67%、67%and85%、72%、65%, the disease-freesurvival rates of1,3and5years were79%、58%、54%and77%、65%、61%, all thedifferences were no statistical significance.7. Single factor analysis showed that T stage, N stage and clinical stage werestatistical difference in the influence on prognosis, while the gender, pathologicaltypes and positive rate of serum EBV-IgA were not.8. Multiple factor analysis exhibited that the age, T stage, N stage, clinic stageand treatment methods were statistical different in the influence on prognosis.Conclusions:1. WHO-Ⅰ nasopharyngeal carcinoma incidence in the Fujian area of5.91%.2. There is no difference between various pathology types and age, N stage,recurrence and metastasis, but significantly difference with the positive rate of serumEBV-IgA and T stage.3. Of the prognostic factors of NPC, the single factor study found T stage, Nstage, clinical stage was significantly associated with the prognosis of nasopharyngealcarcinoma, multivariate study found that age, T stage, N stage, treatment wassignificant correlation with the prognosis of nasopharyngeal carcinoma. The T, Nstage, clinical stage later, the worse the prognosis, comprehensive treatment prognosisis better than radiotherapy alone, but the gender, histological type and prognosisserum EBV-IgA positive cases was not associated with the prognosis ofnasopharyngeal carcinoma.