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Japanese Journal of Cancer Research : Gann logoLink to Japanese Journal of Cancer Research : Gann
. 2001 May;92(5):576–581. doi: 10.1111/j.1349-7006.2001.tb01132.x

Poor Prognosis in Nasopharyngeal Cancer Patients with Low Glucose‐6‐phosphate‐dehydrogenase Activity

Ann‐Joy Cheng 1, Daniel Tsun‐Yee Chiu 1, Lai‐Chu See 2, Chun‐Ta Liao 3, I‐How Chen 3, Joseph Tung‐Chieh Chang 4,
PMCID: PMC5926748  PMID: 11376568

Abstract

Nasopharyngeal carcinoma (NPC) is endemic among well‐defined ethnic groups in several world regions, such as Southeastern China and Taiwan. Glucose‐6‐phosphate‐dehydrogenase (G6PD)‐deficiency, a sex‐linked disorder, is one of the most common enzymopathies in Taiwan. The major role of G6PD is to generate NADPH to protect cells from oxidative damage, which is a major contributing factor to certain degenerative diseases, such as aging and cancer. In view of the coincidence of epidemic distribution of NPC and G6PD deficiency, as well as the house‐keeping function of G6PD in cellular oxidative defense, we investigated the correlation of G6PD activity with NPC. The stage of NPC was classified by AJCC (1997) criteria. G6PD levels were determined in 108 NPC male patients and 75 healthy male individuals. The mean G6PD level of NPC patients was 218.9 U/1012RBC or 7.53 U/g hemoglobin (Hb), being much lower than in normal individuals (260.6 U/1012erythrocytes (RBC) or 8.92 U/gHb). The level of G6PD activity had no correlation with tumor stage or lymph node or distant metastasis, but was significantly correlated with tumor recurrence (P=0.004 when using G6PD=130 U/1012 RBC as cutoff value). These results indicated that low G6PD activity in patients with NPC is associated with poor prognosis.

Keywords: Nasopharyngeal cancer, G6PD, Oxidative defense, Epstein‐Barr virus

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These two authors made equal contributions to the work.

Reference

  • 1.Yu , M. C. “ Nasopharyngeal Carcinoma: Epidemiology and Dietary Factors ,” IARC Sci. Publ , pp. 104 ( 1991. ). IARC; , Lyon , France . [PubMed] [Google Scholar]
  • 2.Fandi , A. and Cvitkovic , E.Biology and treatment of nasopharyngeal cancer . Curr. Opin. Oncol , 7 , 255 – 263 ( 1995. ). [DOI] [PubMed] [Google Scholar]
  • 3.Fandi , A. and Cvitkovic , E.Nasopharyngeal cancer: epidemiology, staging, and treatment . Semin. Oncol , 21 , 376 – 381 ( 1994. ). [PubMed] [Google Scholar]
  • 4.Liebowitz , D.Nasopharyngeal carcinoma: the Epstein‐Barr virus association . Semin. Oncol , 21 , 376 – 381 ( 1994. ). [PubMed] [Google Scholar]
  • 5.Choi , P. H. K. , Suen , M. W. N. , Path , M. R. C. , Huang , D. P. , Lo , K. W. and Lee , J.Nasopharyngeal carcinoma: genetic changes, Epstein‐Barrvirus infection, orboth . Cancer , 72 , 2873 – 2878 ( 1993. ). [DOI] [PubMed] [Google Scholar]
  • 6.Lu , S. , Day , N. E. , Degos , L. , Lepage , V. , Wang , P.‐C. , Chan , S.‐H. , Simons , M. , McKnight , B. , Easton , D. , Zeng , Y. and deThe , G.Linkage of a nasopharyngeal carcinoma susceptibility locus to the HLA region . Nature , 346 , 470 – 471 ( 1990. ). [DOI] [PubMed] [Google Scholar]
  • 7.Huang , D. P. , Lo , K. W. , Choi , P. H. K. , Ng , A. Y. T. , Tsao , S. Y. , Yiu , G. K. C. and Lee , J. C. K.Loss of heterozygosity on the short arm of chromosome 3 in nasopharyngeal carcinoma . Cancer Genet. Cytogenet. , 54 , 91 – 99 ( 1991. ). [DOI] [PubMed] [Google Scholar]
  • 8.Huang , D. P. , Lo , K. W. , van Hasselt , C. A. , Woo , J. K. S. , Choi , P. H. K. , Leung , S. F. , Cheung , S. T. , Cairns , P. , Sidransky , D. and Lee , J. C. K.A region of homozygous deletion on chromosome 9p21‐22 in primary nasopharyngeal carcinoma . Cancer Res. , 54 , 4003 – 4006 ( 1994. ). [PubMed] [Google Scholar]
  • 9.Luzzatto , L. and Battistuzzi , G.Glucose‐6‐phosphate dehy‐drogenase . Adv. Hum. Genet. , 14 , 217 – 329 ( 1985. ). [DOI] [PubMed] [Google Scholar]
  • 10.Rice‐Evans , C. and Burdon , R.Free radical‐lipid interactionsand their pathological consequences . Prog.Lipid Res. , 32 , 71 – 110 ( 1993. ). [DOI] [PubMed] [Google Scholar]
  • 11.Ames , B. N. , Shigenaga , M. K. and Hagen , T. M.Oxi‐dants, antioxidants and the degenerative disease of aging . Proc. Natl. Acad. Sci. USA , 90 , 7915 – 7922 ( 1993. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Guyton , K. Z. and Kensler , T. W.Oxidative mechanisms in carcinogenesis . Br. Med. Bull , 49 , 523 – 544 ( 1993. ). [DOI] [PubMed] [Google Scholar]
  • 13.Du , C. S. , Xu , Y. K. , Hua , X. Y. , Wu , Q. L. and Liu , L. B.Glucose‐6‐phosphate dehydrogenase variants and their frequency in Guangdong, China . Hum. Genet. , 80 , 385 – 388 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 14.Hung , C. S.Favism and its detection . Bull. Assoc. Lab. Med. (ROC) , 7 , 4 – 5 ( 1992. ). [Google Scholar]
  • 15.Fleming L , Cooper J. S. , Henson D. E. , Hutter R. V. P. , Kennedy B. J. , Murphy G. P. , O'sullivan B. , Sobin L. H. and Yarbro J. W. “ AJCC Cancer Staging Manual ,” ed. American Joint Committee on Cancer , pp. 31 – 39 ( 1997. ). Lippincott Williams Wilkins; . [Google Scholar]
  • 16.Chang , J. T. , See , L.‐C , Liao , C.‐T. , Chen , L.‐H. , Leung , W. M. , Chen , S.‐W. and Chen , W.‐C.Early stage nasopharyngeal carcinoma: radiotherapy dose and time factors in tumor control . Jpn. J. Clin. Oncol. , 28 , 207 – 213 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 17.Chang , J. T. , See , L.‐C. , Tang , S. G. , Lee , S. P. , Wang , C.‐C. and Hong , J.‐H.The role of brachytherapy in early‐stage nasopharyngeal carcinoma . Int.J.Radiat.Oncol.Biol. Phys. , 36 , 1019 – 1024 ( 1996. ). [DOI] [PubMed] [Google Scholar]
  • 18.Akaike , T. , Suga , M. and Maeda , H.Free radicals in viral pathogenesis: molecular mechanisms involving superoxide and NO . PSEBM , 217 , 64 – 73 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 19.Schwarz , K. B.Oxidative stress during viral infection: a review . Free Radic. Biol. Med. , 21 , 641 – 649 ( 1996. ). [DOI] [PubMed] [Google Scholar]
  • 20.Staal , J. T. , Roederer , M. and Herzenberg , L. A.Intracellular thiols regulate activation of nuclear factor B and transcription of human immunodeficiency virus . Proc. Natl. Acad. Sci. USA , 87 , 9943 – 9947 ( 1990. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Beck , M. A. , Kolbeck , P. C. , Shi , Q. , Rohr , L. H. , Morris , V. C. and Levander , O. A.Increased virulence of human enterovirus (coxsackievirus B3) in selenium‐deficient mice . J. Infect. Dis. , 170 , 351 – 357 ( 1994. ). [DOI] [PubMed] [Google Scholar]
  • 22.Coleman , C. N. and Stevenson , M. A.Biologic basis for radiation oncology . Oncology , 10 , 399 – 415 ( 1996. ). [PubMed] [Google Scholar]
  • 23.Corrons , J. L. V. , Feliu , E. , Pujades , M. A. , Cardellach , F. , Rozman , C. , Carrearas , A. , Jou , J. M. , Vallespi , M. T. and Zuazu , F. J.Severe glucose‐6‐phosphate dehydrogenase (G6PD) deficiency associated with chronic hemolytic anemia, granulocyte dysfunction, and increased susceptibility to infections: description of a new molecular variant (G6PD Barcelona) . Blood , 59 , 428 – 434 ( 1982. ). [PubMed] [Google Scholar]
  • 24.Nathan , C.Nitric oxide as a secretory production of mammalian cells . FASEB J. , 6 , 3051 – 3064 ( 1992. ). [PubMed] [Google Scholar]
  • 25.Tsai , K.‐J. , Hung , I.‐J. , Chow , C. K. , Stern , A. , Chao , S. S. and Chiu , D. T.‐Y.Impaired production of nitric oxide, superoxide, and hydrogen peroxide in glucose 6‐phosphate‐dehydrogenase‐deficient granulocytes . FEBS Lett. , 436 , 411 – 414 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 26.Al‐Sarraf , M. , LeBlanc , M. , Giri , P.G. S. , Fu , K.K. , Cooper , J. , Vuong , T. , Forastiere , A. A. , Adams , G. , Sakr , W. A. , Schuller , D. E. and Ensley , J. F.Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized inter group study 0099 . J. Clin. Oncol. , 16 , 1310 – 1317 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 27.Chang , J. T. , Chen , L.‐H. , Tang , S. G. , Liao , C.‐T. , Chen , W.‐C. , Leung , W.‐M. , Wang , C.‐H. and Tsai , M.‐H.Acute toxicities and feasibility of altered fractionated radiotherapy in nasopharyngeal carcinoma . Chang Gung Med. J. , 20 , 107 – 114 ( 1997. ). [PubMed] [Google Scholar]

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