Diagnostic and Prognostic Indications of Nasopharyngeal Carcinoma

Abstract

Nasopharyngeal carcinoma (NPC) is a disease that is highly associated with the latent infection of Epstein-Barr virus. The absence of obvious clinical signs at the early stage of the disease has made early diagnosis practically impossible, thereby promoting the establishment and progression of the disease. To enhance the stride for a reliable and less invasive tool for the diagnosis and prognosis of NPC, we synopsize biomarkers belonging to the two most implicated biological domains (oncogenes and tumor suppressors) in NPC disease. Since no single biomarker is sufficient for diagnosis and prognosis, coupled with the fact that the known established methods such as methylation-specific polymerase chain reaction (PCR), multiplex methylation-specific PCR, microarray assays, etc., can only accommodate a few biomarkers, we propose a 10-biomarker panel (KIT, LMP1, PIKC3A, miR-141, and miR-18a/b (oncogenic) and p16, RASSF1A, DAP-kinase, miR-9, and miR-26a (tumor suppressors)) based on their diagnostic and prognostic values. This marker set could be explored in a multilevel or single unified assay for the diagnosis and prognosis of NPC. If carefully harnessed and standardized, it is hoped that the proposed marker set would help transform the diagnostic and prognostic realm of NPC, and ultimately, help prevent the life-threatening late-stage NPC disease.

Keywords: miRNA; nasopharyngeal carcinoma; oncogene; tumor biomarker; tumor-suppressor gene.

Figure 1

A summary of diagnostic and prognostic indications for the detection of nasopharyngeal carcinoma (NPC) using oncogenic and tumor suppressor biomarkers. NP: nasopharyngeal; M&T: mouth and throat; PBMCs: peripheral blood mononuclear cells; MS-PCR: methylation-specific polymerase chain reaction (PCR); MMS-PCR: multiplex methylation-specific PCR; MS-HRM: methylation-sensitive high-resolution melting; qPCR: real-time PCR; EBV: Epstein–Barr virus.