An Institutional Study of Nasopharyngeal Carcinoma and its Clinico-Pathological Presentations among the Populations of Hills and Valleys

Abstract

Background: Nasopharyngeal Carcinoma (NPC) is the most frequently encountered malignancy amongst the neoplasms of nasopharynx. In India, NPC is uncommon in most regions, but high prevalence is observed in North-eastern part of the country. The National Cancer Registry has reported the prevalence of NPC to be 1.82% among all cancers in this region, constituting the eighth most common cancer in the North-eastern states. Methods: Newly diagnosed cases of NPC were studied for a period of 3 years in an institute in Manipur. The origin of the patient (hill or valley) were identified, dietary addiction, clinical presentations, histopathological types and stage at presentation were studied and analysed in the two regions. Results: The study consisted 121 cases of diagnosed NPC, consisting of higher numbers of males then females, making a ratio of 1.95:1. Mean age of the patients was 46±12.34. 74.4% originated from hills and 25.6% from valleys. Consumption of smoked meat comprised 77.7% and was seen more in hilly areas with strong statistical significance. Addiction to smoking, alcohol and smokeless tobacco was seen more among valley patients. Swelling neck was the commonest clinical presentation (93.4%), followed by nasal symptoms (63.6%), auricular features (34.7%), cranio-facial pain (34.7%) and neurological symptoms (12.4%), with greater percentage among hilly populations. Undifferentiated carcinoma was the commonest histological type (73.6%), followed by Non-keratinizing carcinoma (20.7%) and keratinizing squamous cell carcinoma (5.8%). Commonest stage at presentation was stage 4 (38.8%). Conclusion: There is a marked significant difference in the incidence of NPC among the different populations of hills and the valleys. A detailed study of genetic and immuno-histochemical analysis of NPC between the two groups of origin in this part of the country is a necessity.