Algorithm of morphological assessment for predicting clinical course of juvenile nasopharyngeal angiofibroma

Aim. To determine the association between morphological characteristics of tumor growth and clinical manifestations of progression.

Methods. The study included 118 patients with juvenile nasopharyngeal angiofibroma who were examined and treated at the department of head and neck cancer of Cancer Research Center of Uzbekistan from 2003 to 2013. The main group included 69 patients with primary nasopharyngeal angiofibroma, control group - 49 patients with relapsing tumors who underwent surgery. Standard histological examination was performed in all patients. The algorithm for determination of morphological changes degree was developed based on approach proposed by K.M. Mardaleyshvili (1985), which was modified by authors.

Results. Seven most important morphological features of juvenile nasopharyngeal angiofibroma were outlined. On this basis, we proposed to determine the degree of morphological changes for the prediction and treatment monitoring, which is a graded scale for the signs in each of the seven groups. In the main group of patients with cell type of juvenile nasopharyngeal angiofibroma growth, the scores ranged from 10 to 13, marking the 1st degree of morphological changes. Patients with vascular fibrous type of tumor growth had 18-19 points, which corresponds to the 2nd degree of morphological changes in the tumor. Tumor samples of patients with vascular fibrous type of juvenile nasopharyngeal angiofibroma had the most evident morphological changes in the tumor tissue, which corresponded to 3rd degrees with the scores reaching 28.

Conclusion. The proposed algorithm for determining the grade of morphological characteristics may be used for determining the treatment tactics and monitoring the tumor growth in patients with juvenile nasopharyngeal angiofibroma, as well as the prognostic factor.