Differentiation of recurrent nasopharyngeal carcinoma and skull base osteoradionecrosis by Epstein-Barr virus-derived latent membrane protein-1 gene

Objectives: In patients with nasopharyngeal carcinoma (NPC), the differenti ation between recurrent primary cancer and osteoradionecrosis (ORN) is clin ically difficult. Epstein-Barr virus (EBV)-derived latent membrane protein- 1 (LMP-1) has been demonstrated to be highly associated with NPC, The objec tive of this study is to define the role of the LMP-1 gene in the different ial diagnosis of recurrent NPC and ORN, Study Design Prospective. Methods: From July 1998 to June 2000, 15 postirradiated patients with NPC mho were i nitially diagnosed to have skull base ORN underwent endoscopic sequestrecto my, The sequestra mere examined for the presence of the LMP-1 gene and canc er. Results: Two of 15 patients had recurrent cancer and only these two pat ients demonstrated a positive LMP-1 gene in their surgically removed seques tra The presence of the LMP-1 gene in the sequestrum coincided with biopsy- proven local recurrence. Conclusions: The LMP-1 gene is a potential marker to differentiate between recurrent NPC and ORN, The presence of the LMP-1 g ene in patients with ORN may indicate local recurrence.