鼻咽癌诊疗变革:生物标志物与鼻内镜手术协同推进早期治疗发展

doi:10.6040/j.issn.1673-3770.0.2024.542

Abstract

Abstract: The diagnosis and treatment of nasopharyngeal carcinoma has entered a new era characterized by “precision screening, minimally invasive intervention, and preservation of function”. In the screening arena, breakthroughs in Epstein-Barr virus biomarker detection technologies-including CRISPR-associated protein 12a amplification-free assays, P85 antibody testing, and T-cell receptor sequencing-have achieved sensitivity and specificity of 97.9% and 99.3%, respectively, enabling disease prediction 6-12 months before clinical diagnosis. The synergistic application of multi-microRNA panels with narrow-band imaging(NBI)and I-scan virtual chromoendoscopy has shifted screening paradigms from single-marker approaches to multimodal integration.In therapeutics, endoscopic nasopharyngectomy(ENPG)demonstrates superior precision(negative margin rate ≥90%)and functional preservation, achieving a 5-year survival rate of 92.1% in early stage patients while significantly improving quality of life compared to conventional radiotherapy. However, challenges remain, including tumor heterogeneity, limited accessibility of advanced technologies in primary care settings, and restrictive eligibility criteria for ENPG. Future efforts should focus on:(1)multi-omics AI-driven risk stratification models;(2)synergy between surgery and immunotherapy(e.g., neoadjuvant PD-1 inhibitors);(3)portable diagnostic tools;(4)multicenter trials to validate long-term outcomes. Through interdisciplinary collaboration, the management of NPC is moving from empirical to precision medicine with the goal of achieving “early detection rates >80% and functional preservation rates >90%” and ultimately overcoming the global burden of this regionally prevalent malignancy.

Key words: Nasopharyngeal carcinoma, Epstein-Barr virus, Endoscopic nasopharyngectomy

CLC Number:

R739.6

QIN Debo, XUE Jiancheng, YANG Wenyue, HU Bing, CHEN Tao, YU Yanping, MENG Qingguo, SUN Huanji, MIAO Beiping, LU Yongtian. Changing the diagnosis and treatment of nasopharyngeal cancer: biomarkers and nasal endoscopic surgery synergise to advance early treatment development[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 85-92.

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Changing the diagnosis and treatment of nasopharyngeal cancer: biomarkers and nasal endoscopic surgery synergise to advance early treatment development

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[13]	YANG Kaiyan, TANG Fengzhu, QIN Qicai, LI Xuxiang, FENG Dayi, NONG Fengjing, YANG Qiuyun. Expression of abnormal spindle-like microcephaly associated protein in nasopharyngeal carcinoma and its clinical significance [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 18-25.
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