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Abstract：
Nasopharyngeal carcinoma (NPC) is an aggressive malignancy with high propensity for lymphatic spread and distant metastasis. It is prominent as an endemic malignancy in Southern China and Southeast Asia regions. Studies on NPC pathogenesis mechanism in the past decades such as through Epstein Barr Virus (EBV) infection and oncogenic molecular aberrations have explored several potential targets for therapy and diagnosis. The EBV infection introduces oncoviral proteins that consequently hyperactivate many promitotic pathways and block cell-death inducers. EBV infection is so prevalent in NPC patients such that EBV serological tests were used to diagnose and screen NPC patients. On the other hand, as the downstream effectors of oncogenic mechanisms, the promitotic pathways can potentially be exploited therapeutically. With the apparent heterogeneity and distinct molecular aberrations of NPC tumor, the focus has turned into a more personalized treatment in NPC. Herein in this comprehensive review, we depict the current status of screening, diagnosis, treatment, and prevention in NPC. Subsequently, based on the limitations on those aspects, we look at their potential improvements in moving towards the path of precision medicine. The importance of recent advances on the key molecular aberration involved in pathogenesis of NPC for precision medicine progression has also been reported in the present review. Besides, the challenge and future outlook of NPC management will also be highlighted.
摘要：
鼻咽癌（NPC）是一种侵袭性恶性肿瘤，具有很高的淋巴扩散和远处转移倾向。在中国南部和东南亚地区，它是一种地方性恶性肿瘤。在过去的几十年中，关于NPC发病机制的研究，例如通过EB病毒（EBV）感染和致癌分子畸变，已经探索了几个潜在的治疗和诊断靶标。EBV感染引入了致癌病毒蛋白，从而过度激活了许多有丝分裂途径并阻断了细胞死亡诱导剂。EBV感染在NPC患者中非常普遍，以至于使用EBV血清学测试来诊断和筛查NPC患者。另一方面,作为致癌机制的下游效应物，促有丝分裂途径可以被潜在的治疗性利用。鼻咽癌具有明显的异质性和明显的分子畸变,在NPC中，焦点已经变成了更个性化的治疗。在这次全面审查中，我们描述了筛查的现状，诊断,治疗,NPC的预防。随后，基于这些方面的局限性，我们看看他们在迈向精准医疗道路上的潜在改进。本综述也报道了NPC发病机制中涉及的关键分子畸变对精准医学进展的重要性。此外,人大管理的挑战和未来前景也将得到强调。
