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To evaluate a newly developed noninvasive ambulatory, quantitative polymerase chain reaction (Q-PCR) Epstein-Barr virus (EBV) DNA detection and screening system (NP Screen™) for nasopharyngeal carcinoma (NPC).Correlation of the nasopharyngeal epithelial EBV-DNA levels and clinical findings by nasopharyngoscopy and final pathologic diagnosis of NPC with biopsy.Multicenter ENT/Oncology clinics in Hong Kong (Radiation Oncology Clinic at the Queen Elizabeth Hospital and Radiation Oncology Clinic and Head and Neck Clinic, Queen Mary Hospital, University of Hong Kong) and in Toronto, Canada (the Otolaryngology-Head and Neck Clinic at the Rouge Valley Health System and 2 large ENT practices in Toronto).A single-use trans-oral brush was used for rapid, nontraumatic nasopharyngeal (NP) epithelial cells DNA harvest in 600 Chinese patients, combined with a preservation and shipping kit for remote, real-time Q-PCR EBV DNA determinations.All 600 patients had NP brushings using NP Screen in an ambulatory environment, and no adverse events or complications were recorded. A final 578 patients were included with sufficient amount of DNA for completion of the Q-PCR assay. Of these 578 patients, 94 were confirmed positive for NPC histologically. The study yielded a sensitivity of 98.9%, specificity of 99.3%, positive predictive value (PPV) of 96.9%, and negative predictive value (NPP) of 99.7% for NP Screen in detecting NPC. Endoscopy had a sensitivity of 94%, specificity 97.1%, PPV 85%, and NPP 98.9%.The trans-oral brushing system fulfills the characteristics of a noninvasive, sensitive, specific detection method suitable for routine, large-scale ambulatory NPC risk assessment for high-risk NPC populations.

Objectives:Obstructive sleep apnea (OSA) is a common sleep disorder due primarily to upper airway obstruction. Certain ethnic groups, particularly Chinese, are more susceptible to a severe degree of OSA irrespective of body weight due in part to inherent narrow upper airway anatomy. In this study, we investigated the treatment outcome of combined upper airway surgeries: septoplasty (SP), turbinate reduction (TR), tonsillectomy, and uvulopalatoplasty (UVPP) on OSA in this ethnic group who have clinical identifiable upper airway anatomical obstruction and are unable to tolerate continuous positive airway pressure (CPAP) treatment.Methods:A retrospective study to analyze the effect of either: (1) SP and TR (inferior turbinectomy) only or (2) in combination with UVPP (partial uvulectomy and lateralization of palatal pillars) and standard tonsillectomy, on Chinese patients diagnosed with OSA. Outcome measures were obtained from pre- and postoperative polysomnographs (PSG) where sleep parameters, AHI, and oxyge...