الفهرس 
Embryology of NasopharynxOnly 14 pages are availabe for public view
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Abstract
The present study was designed to assess the relationship between Epstein-Barr virus infection and frequency of nasopharyngeal carcinoma and the role of quantitative EBV DNA detection as a diagnostic, prognostic and follow-up modality for NPC patients.
All patients underwent clinical examination, both general and local examination. Then, patients had MRI examination to assess local and nodal involvement. Nasopharyngeal endoscopic examination was performed and tissue biopsy was taken and divided into two parts; the first sent for histopathological examination for lesion grading according to WHO grading and the second for qualitative and quantitative determination of tissue EBV DNA. Blood sample was obtained for quantitative estimation of EBV DNA plasma load.
The study included 45 patients with mean age of 56.8±8.4; range: 35-71 years. Ten patients (22.2%) had age range of 45-50 years, 16 patients (35.6%) had age ranged between 52-60 years and another 17 patients were older than 60 years.
The majority of patients (n=33) were males and only 12 females were encountered with a male: female ratio of 2.75:1. There were 31 smokers (68.9%); 28 males and 3 females, while the other 5 males and 9 females were non-smokers with a significant increase (X2=47.13, p<0.001) of the frequency of male smokers with NPC compared to female patients. Moreover, smoker patients were significantly (P<0.05) younger than non-smokers and smoker females were significantly younger (P<0.05) than non-smoker females, while smoker males were non-significantly (P>0.05) younger than smoker males.
MRI detected in 26 patients (57.8%), while the other 19 patients (42.2%) had no nodal involvement, 10 patients (22.2%) had N1 nodal involvement, another 10 patients (22.2%) had N2 involvement and the remaining 6 patients (13.4%) had N3 nodal involvement.
According to TNM staging; 3 patients (6.6%) had stage 0 (T in situ N0 M0) lesions and 6 patients (13.3%) had stage I (T1 N0 M0) lesions, while 12 patients (26.7%) had stage II lesions, 15 patients (33.3%) had stage III lesions and 9 patients (20%) had stage IV lesions.
According to WHO histopathological staging 22 patients (48.9%) had lesions of WHO pathological grade I and 14 patients (31.1%) had lesions of WHO pathological grade II lesions; while the other 9 patients (20%) had lesions of WHO pathological grade III. There was a positive significant correlation (r=0.699, P<0.001) between WHO pathological and TNM staging.
Through the present study qualitative PCR detected EBV DNA in all studied tissue specimens and blood samples obtained of the 45 cases of NPC, irrespective of the stage or pathological grade.
Mean EBV DNA plasma load was 2124±663; range: 1095-3950 copies/ml. There was a positive significant correlation between mean plasma viral load and both TNM stage (r=0.540, P=0.025) and WHO grade (r=0.606, P=0.001).
Viral DNA was detected in only 10 patients (22.2%) after completion of treatment with a mean EBV DNA plasma load of 61.5±33.7copies/ml. There was a significant decrease of mean plasma viral load after