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Nasopharyngeal Carcinoma: Etiology and Control WORLD HEALTH ORGANIZATION INTERNATIONAL AGENCY FOR RESEARCH ON CANCER NASOPHARYNGEAL CARCINOMA: ETIOLOGY AND CONTROL Proceedings of an International Symposium jointly supported by 1ARC, the National Cancer Institute (USA) and the Japan Society for the Promotion of Scieпce and help in Kyoto, Japan, 4-6 April 1977 EDITORS G. dе-THÉ Y. ITO TECHNICAL EDITOR FOR IARC W. DAMS IARC Scientific Publications No. 20 INTERNATIONAL AGENCY FOR RESEARCH ON CANCER LYON 1978 CONTENTS Foreword • ix Introduction кi Participants . xiii PATHOLOGY OF NASOPHARYNGEAL CARCINOMA Histological typing of nasopharyngeal carcinoma K. shanmugaratnam . 3 Histological types of nasopharyngeal carcinoma in an intermediate risk area M. Cammoun, R. Elloui, J. Behi & R. Ben Attia . 13 Histopathological types of nasopharyngeal carcinoma in а. low- risk area: Japan H. sugano, 5. Sawaki, G. Sakamoto & T. Hirayama 27 The histораthologiсаL spectrum of iiasopharyngeal carcinoma L.H. Weiland . 41 Diagnosis and differential diagnosis of lymphoepithelial carcinoma in lymph nodes: histological, cytological and electron-microscopic findings K. Lennert, E. Kaiserling & T. 14azzaпti . 51 A histopathological study of lymphoid tissue reaction to metastatic nasopharyngeal carcinoma in nude mice 1.-C. Cheri, A. Kawamura, Jr, Z. ]1urata, K. Hamajima & M. Osono . 65 Animal models for nasopharyngeal carcinoma D.V. Ablashi, J.М. Easton & R. Claser S5 Discussion 5ш тarу - м. САЮIОпN . 95 CLINICAL ASPECTS OP NASOPHARYNGEAL CARCINOMA. Stage classification of nasopharyngeal carcinoma: A review J.Н.С. Ho . 99 Nasopharyngeal carcinoma iп children and adolescents in Tunisia: Clinical aspects and the paraneoplastic syndrome R. Ellouz, M. Cammoun, R. Ben Attia & J. Bahi . 115 Clinical aspects and natural history of nasopharyngeal carcinoma in Western Europe Y. Cachin, H. Sancho-Garnier, G. Schwaab, P. Marandas . 131 Analytical aspects it symptoms of nasopharyngeal malignancies Ѕ. Sawaki, H. Sugano & T. Hirayama . 147 EPIDEMIOLOGY OF NA50PHARYNGEAL CARCINOMA Descriptive and analytical epidemiology of nasopharyngeal cancer T. Hirayama . 167 Variations in nasopharyngeal cancer incidence among specific Chinese communities (dialect groups) in Singapore K. Shanmugaratnam . 191 Etiological factors in nasopharyngeal carcinoma: A hospital-based, retrospective, case-control, questionnaire study K. Shaпmugaratnam, C.Y. Tye, Е.H. Gob & K.B. Chia . 199 Environmental factors in the etiology of nasopharyngeal carcinoma: Report on a case-control study in Hong Kong A. Geser, N. Charnay, N.E. Day, H.С. Ho & G. de-Thë . 213 Environmental backgrounds of young Chinese nasouharyngeal carcinoma patients Е.N. Anderson, Jr, M.L. Anderson & H.C. Ho . 231 Epidemiology of malignant tumours of the nasopharynx in France: Retrospective and prospective studies Ј. Brughre, H. 5ancho-Garnier, D. Point & G. Schwaab . 241 Discussion of risk factors for nasopharyngeal carcinoma В .E. Henderson & E. Louie . 251 -iv- ETIOLOGY OF NASOPHARYNGEAL CARСIN0?А - GENETIC AND CHEMICAL FACTORS HLA frequencies in cancer: A third study S.T. Perdue, P.1. Terasaki & M.R. Mickey . 263 Nasopharyngeal carcinoma and histocompatibility antigens M.J. Simons, S.Н. Chan, G.E. Wee, K. 5haпmugаratnаm, E.H. Gob, J.H.C. Ho, J.C.W. Chau, Ѕ. Darmaliпgam, 1. Prasad, H. Betuel, N.E. Day & G. de-Thë . 271 Genetic components in susceptibility to nasopharyngeal carcinoma R.L. Kirk, N.M. Blake, S. Serjeantson, M.J. Simons & S.H. Chan . 283 Cytogenetic observations on the malignant epithelial cells and infiltrating lymphocytes of nasopharyngeal carcinoma J.E. Jarvis, S. Finerty, М.~. Epstein, P.A. Tremper, G. Ball & B.C. Giovanella . 299 Analysis for volatile nitrosamines in salt-preserved foodstuffs traditionally consumed by Southern Chinese 309 D.Р. Huang, T.A. Gough & J.H.C. ho . Carcinoma of the nasal and paranasal regions iп rats fed Cantonese salted marine fish 15 D.P. Huang, D. Saw, T.B. Teob, J.H.C. Hо . З 329 рiscussiarг Sumтary - N.E. DAY . ETIOLOGY 0F NASOPHARYNGEAL CARCINOMA - VIROLOGICAL FACTORS Epstein-Barr virus - Discovery, properties and relationship to nasopharyngeal carcinoma M.A. Epstein . 333 The association between undifferentiated nasopharyngeal carcinoma and Epstein-Barr virus shown by correlated nucleic acid hybridization and histopathological studies I. Andersson-Anvret, N. Forsby, G. KLein & W. Henle . 347 Morphological transformation of nasopharyngeal epithelial cells in vüro by Epstein-Baгr virus from В95-8 cells D.P. Huang, J.Н.С. Ho & M.H. Ng . Э59 -v- Epstein-Barr virus-regulation studies on somatic-cell hybrids derived from the fusion of Burkitt's lymphoma and nasopharyngeal carcinoma cells with human or mouse partners . G. Klein . 3б9 Epstein-Barr virus epithelial cell interaction and its implication in the etiology of nasopharyngeal carcinoma G. Lenoir & G. de-Ihd . 377 Early and late components of Epstein-Barr virus-associated membrane antigen in superinfected Daudi cells and their reactivity with sera from nasopharyngeal carcinoma patients Y. Hinuma, T. Sairenj i & M. Maeda . 385 Heterogeneity of Epstein-Barr virus deтived from РЗНR-1 cells H. zur Hansen & K.-0. Fresen . 391 Expression of latent Epstein-Barr virus geuoiues in human epithelial/Burkitt's lymphoblastoid hybrid cells M. Nonoyama, A. Tanaka & R. Glaser . 397 Aetection and quantitation of adenovirus type 12 transforming DNA segments and their application in etiological studies of human neoplasia 403 K. Fujinaga, S. Уапо, S. Ojima & Y. Sawada . Interaction between Epstein-Barr virus and type-G virus in human cells T. Osato, K. Yairiainoto, Т. I{atsuo, T. Aya, F. Mizuno & M. Nonoyama . 413 . 421 Discгcssion Swтmar2es - W. HENLE . ETIOLOGY OF NA50PHARYNGEAL CARCINOMA - IMMUNOLOGICAL FACTORS Epstein-Barr virus-related serology in riasopharyngeal carcinoma and controls W. Henle, G. Henle & J.H.C. Ho . 427 Clinical evaluation of EBV serology in American patients, with nasopharyngeal carcinoma G.R. Pearson, H.L. Coates, H.B. Neel III, P. Levine, D. Ab1as1i & T. Easton . 439 -vi- The genetic and aritigeIlic basis for the IgA antibody response to Epstein-Barr viral capsid antigen М.H. Ng, H.С. Ho & H.С. Kwan . 449 Presence of Epstein-Barr virus specific IgA in saliva of nasopharyngeal carcinoma patients: their activity, origin and possible clinical value C. Desgranges & G. de-Thë . 459 Differences in EBV-antibocly titres of patients with nasopharyngeal carcinoma originating from high, intermediate and low incidence areas C. de-Thë, M.F. Lavoud & L. Muenz . 471 Cell-mediated immunity, Epstein-Barr virus and nasopharyngeal carcinoma P.Н. Levine, J.-P. LainelnLn & D.A. Stevens . 483 General immunological status of nasopharyngeal carcinoma patients in Singapore S.Н. Chan, E.H. Gob, T.H. Khor & T.S. Chew . 495 Effect of levamisole on cell-mediated iттnипе responses in patients with nasopharyngeal carcnLnonia E.H. Gob, S.Н. Chan & M.J. 5iшопs . 503 Changes in T-cell subsets and their clinical significance in cancer patients J. Tata, T. Shimbo & Ѕ . Sawaki . 511 Autoantibodies (cold lymphocytotoxiris, antiactin antibodies and antinuclear factors) in nasopharyngeal carcinoma patients J.-P. Lamelin, J.P. Revillard, G. Gabbiani & G. de-Thë . 523 537 Discussion Sиmmаrгу - T. TACHIBANA . PRESENT CONCEPTS ON TREATMENT AND CURRENT CLINICAL RESEARCH In vivo cell-mediated immunity in Chinese patients. with. nasopharyngeal carcinoma Ј.Н.С. Ho, J.C.W. Chau, K.C. Tse, M.H. Ng & P.H. Levine 545 Clinical evaluation of cytological diagnosis of nasoph,aryngeal malignancies R. Molinari, s. Pilotti & F. Rilke . 553 -vii- European Organization for Research on Treatment of Cancer (E.O.R.T.C.) controlled trials of chemotherapy as an adjuvant or palliative treatment of nasopharyngeal carcinoma . R. Molinari . 5б5 Use of immunological studies in evaluating the clinical course of nasopharyngeal carcinoma ki, A. Kawamura., Jr & T. Tachibana . 575 S. Sаwа — R.A. MANAKER . 587 Discussion Suтпдnarгу RECOMЛL} TШАТIОN5 Histopathological classification . 593 Clinical staging . 594 Epidemiology 597 Genetics . 599 Virology . 601 60 Imuпology . Э Histological classification of tumours of the nasopharynx recommended by World Health Organization . 605 609 INDEК OF AUTHORS . FOREWORD I am frequently asked about the progress bеirгg made in cancer research. In this volume we have an opportunity to review the information available today and to compare it with that presented at the first symposium on nasopharyngeal carcinoma held in 1.964 in Uingaроге1 , and organized by Professor K. 5hanrеugaratnam and Dr C.S. Muir, under the auspices of the International Union Against Cancer. At that time, emphasis was laid on the possibility that inhaled chemicals were the potential causes. Although the role of viruses and especially adenoviruses was considered, the results were negative, and no mention was made of Epstein-Barr virus. The 1.964 meeting agreed that racial susceptibility was an important factor, but no objective criteria were identified, and the risk аttributaые to such susceptibility remained uncertain. There was no discussion about the role of immunological factors in the disease. The present volume shows that scientists now accept the need to utilize a шеltidiесlрllnrу approach in investigating human cancer. It is further obvious that Laboratory scientists are learning from epidemiologists and vice versa. A series of papers are included that further implicate the Epstein- Parr virus as a cause of nasopharyngeal cancer. Several papers emphasize the importance of the role that immunological factors may play in
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