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The prognostic value of histological typing in nasopharyngeal carcinoma

机译：组织学分型对鼻咽癌的预后价值

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摘要

We analyzed the relation of histological typing in late stage nasopharyngeal carcinoma (NPC) with clinical outcome and excision repair cross complementation group 1 protein (ERCC1) expression. The biopsy specimens of 259 patients with NPC were reviewed by two pathologists for classification according to 2005 WHO subtypes. The patients were of stage III to IVB and treated with radiotherapy (RT) alone or concurrent-adjuvant chemoradiotherapy (CRT). Expression of ERCC1 protein detected by immunohistochemistry on paraffin sections was correlated with the histological subtypes. There were 10 cases (3.9%) of differentiated non-keratinizing carcinoma compared with 249 cases of conventional undifferentiated carcinoma. The former exhibited more advanced squamous differentiation with 3 cases belonging to the papillary variant. The degree of ERCC1 expression was generally high compared with the median of the cohort. Clinically, the differentiated group fared poorly compared with the undifferentiated group with respect to loco-regional failure-free rate, distant failure-free rate, disease-free survival and overall survival (p ≤ 0.05). Treatment modality of the 10 patients (5 RT, 5 CRT) was similar to the whole cohort. Contrary to general acceptance that differentiation of non-keratinizing NPC had little bearing on prognosis, we demonstrated that in endemic area differentiation in fact conferred a worse prognosis in stage III to IVB patients. There was positive correlation of differentiation with ERCC1 expression. We advocate precise histological typing of NPC in pathology report for prognostic purpose and outcome correlation.
机译：我们分析了晚期鼻咽癌（NPC）的组织学分型与临床结局和切除修复交叉互补1组蛋白（ERCC1）表达的关系。两名病理学家根据2005年WHO的亚型对259例NPC患者的活检标本进行了分类。这些患者为III至IVB期，仅接受放射治疗（RT）或同时进行辅助放化疗（CRT）进行治疗。免疫组化法检测石蜡切片中ERCC1蛋白的表达与组织学亚型相关。分化型非角化癌10例（3.9％），而常规未分化癌249例。前者表现出更高级的鳞状分化，其中3例属于乳头状变体。与队列中位数相比，ERCC1表达程度通常较高。在临床上，就局部区域无故障率，远距无故障率，无病生存率和总生存率而言，分化组与未分化组相比表现较差。 10例患者的治疗方式（5例RT，5例CRT）与整个队列相似。与普遍认为非角化NPC的分化对预后的影响相反，我们证明了在流行地区，事实上，III期至IVB患者的预后较差。分化与ERCC1表达呈正相关。我们提倡在病理报告中对NPC进行精确的组织学分型，以达到预后目的和结果相关性。

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