To investigate the impact of the number of chemotherapy cycles (NCTC) on the occurrence of radiation-induced trismus (RIT) in locally advanced nasopharyngeal cancer (LA-NPC) patients who underwent definitive concurrent chemoradiotherapy (CCRT) followed by consolidation chemotherapy. A retrospective analysis was conducted on LA-NPC patients who underwent CCRT between July 2011 and March 2024. The cohort was categorized based on the NCTC (< 3 vs. ≥ 3) and total NCTC (TNCTC: < 4 vs. ≥ 4). The primary objective of this study was to investigate the correlation between the RIT [a maximum mouth opening (MMO) of ≤ 35mm] incidence and the NCTC and TNCTC parameters. A total of 293 patients were included in the study. The incidence of RIT was significantly higher in patients receiving NCTC ≥ 3 (32.5% vs.16.9%; P < 0.001) and TNCTC ≥ 4 (32.4% vs.15.0; P < 0.001). Univariate analysis identified NCTC ≥ 3 (P < 0.001), TNCTC ≥ 4 (P < 0.001), smoking history (P = 0.03), pre-treatment MMO < 41mm (P = 0.003), and advanced tumor stage (T3-4) (P < 0.001) as independent predictors of RIT. Multivariate analysis revealed that all factors were independent and significant predictors of RIT in this patient group (P < 0.05 for each). The findings of this retrospective study indicate that higher NCTC and TNCTC are independently correlated with an increased risk of RIT in LA-NPC patients undergoing CCRT.

Nasopharyngeal Carcinoma is an epithelial malignancy originating from the nasopharynx which is posterior to the nasal cavity. Chemotherapy is one of the therapies that can be given to patients with malignancy. Chemotherapy has some side effects, depending on the chemotherapy agent given. Nausea and vomiting are common side effects in patients undergoing chemotherapy. Purpose of this study to provide an overview of lemon aromatherapy as a nursing intervention in reducing nausea and vomiting in nasopharyngeal cancer patients undergoing chemotherapy. The method used is a case study, done by analyzing nursing care in one patient with a diagnosis of nasopharyngeal cancer undergoing chemotherapy. The results of nursing care carried out for 4 days discovered a decrease in nausea and vomiting as showed by VAS measurements of nausea, vomiting frequency, heart rate, meal portions, and salivation. Analysis of lemon aromatherapy as a nursing intervention in reducing nausea and vomiting in nasopharyngeal cancer patients during chemotherapy treatment found a decrease in nausea and vomiting as evidenced by a decrease in the VAS nausea scale from VAS six on the first day to VAS zero (no nausea) on the fourth day. Therefore, giving lemon aromatherapy helps in reducing nausea and vomiting during chemotherapy.

Following the publication of the above article, a concerned reader drew to the Editor's attention that one set of the tumor data comparing between the 'CD44+' experiments in Fig. 4A and the 'CON' experiments in Fig. 4B on p. 428 had apparently been duplicated; moreover, several of the images of various of the mice shown in this figure looked more similar in appearance than might have been expected. Furthermore, upon performing an independent analysis of the data in this paper in the Editorial Office, it came to light that the data panel showing the results of the migratory assay experiment relating to the 'KD' group in Fig. 2B on p. 926 contained an internally duplicated area that would have been difficult to attribute to coincidence. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. Therefore, the Editor of Oncology Reports has decided that this paper should be retracted from the Journal on account of a lack of confidence in the presented data. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 35: 923‑931, 2016; DOI: 10.3892/or.2015.4414].

Foxp3+ regulatory T cells (Tregs) heavily infiltrate malignant tumors and restrict antitumor immunity. These tumor-infiltrating Tregs (TI-Tregs) adopt a distinct phenotype by expressing a unique set of genes. This TI-Treg gene expression signature is conserved in TI-Tregs across species and tumor types and stages, suggesting the presence of a common inducing mechanism in the tumor microenvironment (TME). However, identity of such a mechanism remains elusive. Here, we show that prostaglandin E2 (PGE2) produced in TME directly acts on its receptor EP2/EP4 on Tregs to induce the TI-Treg phenotype. PGE2 added to TCR-activated Tregs induces a set of genes, many of which are included in the TI-Treg signature, in both induced Tregs (iTregs) and naturally occurring Tregs (nTregs) via EP2/EP4- cAMP-PKA pathway. Concomitantly, PGE2-treated Tregs exhibit potent suppressive activity to CD8+ T cells and strongly inhibit their proliferation in an EP4 dependent manner. Consistently, selective loss of EP2 and EP4 in mouse Tregs reduces expression of those genes in Tregs infiltrating Lewis lung carcinoma 1 (LLC1) mouse tumor and significantly delays the tumor progression. In human FOXP3+iTregs, PGE2-EP4 signaling upregulated the expression of Treg signature genes, FOXP3, CD25, and CTLA-4 as well as a typical TI-Treg signature gene, 4-1BB, and enhanced suppressive activity. Furthermore, analysis of single-cell RNA sequencing of nasopharyngeal cancer patients demonstrates preferential expression of the TI-Treg signature genes in Tregs infiltrating the PTGS2hi tumor group compared to the PTGS2lo tumor group. These findings suggest that PGE2-EP2/EP4 signaling is one of the core mechanisms inducing the TI-Treg phenotype in TME for tumor growth.

Influence of blood EBV-DNA level on survival of patients with nasopharyngeal cancer on immune checkpoint inhibitors: a meta-analysis.

ABSTRACTCancers of the lip, oral cavity, and pharynx (LOCP) represent a substantial public health challenge worldwide. Using GLOBOCAN national estimates of incidence, detailed cancer registry data from Cancer Incidence in Five Continents, and population statistics from the United Nations, the authors report the distribution of new cases of LOCP cancers in 185 countries by sex in 2022. Age‐standardized incidence rates were calculated. For countries lacking registry data, regional averages from high‐quality registries were used to impute subsite‐specific estimates. Worldwide, 758,000 people were diagnosed with LOCP cancers in 2022, with oral cavity cancer accounting for approximately 42% of cases, followed by oropharynx (19.3%), nasopharynx (15.9%), hypopharynx (11.4%), salivary gland (7.3%), and lip (4.2%) cancers. Oral cavity cancer was the most frequent LOCP subsite among women in 141 countries and among men in 93 countries, and incidence rates were highest in countries in South‐Central Asia. Oropharyngeal cancer was the most frequent LOCP subsite among men in 44 countries and among women in five countries across Europe, Northern America, South America, Australia, and New Zealand. Nasopharyngeal cancer was the most common subsite among men in 39 countries and women in 23 countries, mainly in Northern Africa, Middle Africa, and Eastern and South‐Eastern Asia. Rates of hypopharyngeal and salivary gland cancers were low globally, although the incidence burden was greater than that of lip cancer. The authors discuss incidence patterns in relation to disease etiology and the prospects of delivering effective cancer control measures, spanning primary prevention, early detection, cancer treatment, and survivorship.

This study develops a Quality of Care Index (QCI) to evaluate global disparities in care quality for five head and neck cancer (HNC) subtypes-thyroid, larynx, lip and oral cavity, nasopharynx, and other pharynx cancers-from 1990 to 2021, addressing the issue of existing indicators not fully reflecting cancer quality. We developed a QCI for five HNC subtypes using data from the Global Burden of Disease Study 1990-2021. The QCI was constructed through principal component analysis of six epidemiological indicators. Trends in age-standardized DALY rates (ASDR) and QCI were assessed globally, regionally, nationally and by Socio-demographic Index (SDI). From 1990 to 2021, ASDR declined markedly for larynx and nasopharynx cancers, whereas thyroid, lip and oral cancer, and other pharynx cancers decreased only in high-SDI regions, remaining stable or rising in low- and middle-SDI regions. QCI improved for all subtypes. High-SDI regions consistently exhibited a 'high-quality, low-burden' pattern, with the highest absolute QCI values but limited relative gains; low-SDI regions, in contrast, faced "high burden and low quality" and, despite lower absolute QCI, showed the largest improvements over time. Subtype-specific patterns were evident: nasopharynx cancer achieved the greatest QCI gains, larynx cancer showed consistent ASDR decline and QCI improvement across all SDI levels, and thyroid cancer improved in QCI despite ASDR increases in low- to middle- SDI regions. Lip and oral cancer, and other pharynx cancers exhibited persistent high burden in lower SDI regions, with modest QCI gains. Global HNC care quality has improved, but reductions in disease burden and gains in QCI were not fully aligned. Substantial inequalities persist across cancer subtypes and SDI regions. Strengthening care infrastructure and optimizing HNC management in resource-limited settings are needed to reduce disparities.

Development and validation of the symptom assessment scale for patients with nasopharyngeal cancer undergoing radiotherapy.

Relationship between nasopharyngeal cancer stage with interleukin-6 and interleukin-8

Nasopharyngeal carcinoma (NPC), a type of epithelial cancer, is frequently found in Southeast Asia and Southern China. The Epstein-Barr Virus (EBV) significantly contributes to the development of NPC by producing latent proteins, particularly Latent Membrane Protein 1 (LMP-1). This protein acts as an oncoprotein, activating several signaling pathways, including NF-κB, JAK/STAT, and PI3K/Akt. Consequently, this factor facilitates cellular proliferation, angiogenesis, and the inhibition of apoptosis. A multitude of investigations have established a correlation between the expression of LMP-1 and both the malignancy of tumors and the clinical outcomes of individuals afflicted with KNF. LMP-1 detection can be achieved through immunohistochemistry (IHC), polymerase chain reaction (PCR), or in situ hybridization (ISH) techniques, each exhibiting varying degrees of sensitivity and specificity. Furthermore, LMP-1 serves as a critical diagnostic and prognostic indicator, and it also presents a potential target for molecular interventions in nasopharyngeal cancer.

Nasopharyngeal cancer (NPC) is one of the most prevalent head and neck cancers. Fear of cancer recurrence (FCR) is a psychological state experienced by cancer patients, characterized by concern and worry about the possibility of cancer recurrence. Long-term and persistently high-level FCR is associated with emotional distress, sleep disorders, and decreased treatment compliance in patients, seriously affecting their quality of life and increasing medical costs. This study employed a phenomenological approach to explore the perceptions of fear of cancer recurrence (FCR) and its impacts on Chinese patients with nasopharyngeal cancer (NPC) who have received radiotherapy. We conducted semi-structured interviews, guided by the theoretical model of FCR, with 18 patients diagnosed with NPC at a tertiary hospital in Shanghai, China, between August 2023 and January 2024. All data were transcribed verbatim and then analyzed by two researchers using Colaizzi's descriptive phenomenological method. Five themes were identified, including (1) internal triggers of FCR, (2) external triggers of FCR, (3) illness perceptions, (4) challenges and changes due to FCR, and (5) adaptations and responses to FCR. FCR in patients with NPC is a complex, multidimensional phenomenon involving physiological, psychological, and social dimensions. Our study provides a unique and in-depth understanding of the triggers, challenges, and changes associated with FCR, as well as the adaptations and responses of patients with NPC. We suggest that future research focus on developing appropriate measures and interventions to address FCR in this patient population.

Background: Head and neck squamous cell carcinoma (HNSCC) accounts for an estimated 450,000 deaths annually worldwide, presenting a significant clinical burden (1). Poor survival rates are largely due to the lack of reliable screening tools for early detection, as current methods offer limited insight into tumor invasiveness and metastasis potentials. While previous studies have explored HNSCC risk factors, predicting disease’s likelihood remains challenging due to lack of reliable screening tools. This retrospective study aims to creating a risk stratification scoring system for HNSCC, ultimately improves early detection and management for high-risk patients. Methods: We developed a risk scoring system using data from the health system Geisinger, incorporating demographic and comorbidity factors such as sex, age, race, BMI, HPV history, smoking, alcohol use, diabetes, and prior diagnoses of leukoplakia or erythroplakia. The study included patients age 18 and older diagnosed with HNSCC between 2000 and 2024, excluding those with HIV/AIDS. Categorical variables were summarized with frequencies and percentages, while medians were reported for continuous variables. We used multiple logistic regression and descriptive analysis to assess the association between each risk factor and HNSCC development. Results: Of the total 2,435 patients who were diagnosed with HNSCC, 1,607 (66.0%) are patients age 60 years or older at diagnosis. There are 620 females (25.5%) and 1,815 males (74.5%). Mean BMI is 27.5 (SD 7.0) with 707 patients (29.0%) having obesity. One thousand four hundred eighteen patients (58.2%) use tobacco, 949 patients (39.0%) use alcohol, 605 patients (24.8%) have diabetes, 62 patients (2.5%) have history of leukoplakia or erythroplakia, 14 patients (0.6%) have history of HPV, and 59 patients (2.4%) were previously diagnosed with HNSCC. Among 778 patients with known pack years, 109 (14.0%) smoked less than 10 pack years, 669 (86%) smoked at least 10 pack years, and 536 smoked at least 20 pack years (68.9%). Among 227 patients with known alcohol use frequency, 123 (54.2%) consumed less than 10 drinks per week and 104 (45.8%) consumed at least 10 drinks per week. Type/location of tumor: 621 (25.5%) tongue cancer, 358 (14.7%) tonsillar cancer, 46 (1.9%) nasopharyngeal cancer, 72 (3.0%) oropharyngeal cancer, 54 (2.2%) palatine cancer, 202 (8.3%) lip cancer, 60 (2.5%) gum cancer, 114 (4.7%) floor of mouth cancer, 270 (11.1%) glottic cancer, 259 (10.6%) supraglottic cancer, 54 (2.2%) pyriform sinus cancer, and 325 (13.3%) others. Patients who scored 6 or higher are classified as high risk, 4–6 is medium risk, and 1–3 is low risk of HNSCC. Conclusion: Tobacco use is identified as the highest risk factor that contributes to developing HNSCC. Patients scoring 6 or more points should undergo more rigorous and proactive screening for early detection. Given the severity of HNSCC, implementing this scoring system is crucial for reducing undiagnosed cases and improving patient outcomes. Future study should focus on which factors are associated with earlier onset of HNSCC and prediction of survival rate based on risk scores.

Percutaneous endoscopic gastrostomy (PEG) placement is used for maintaining nutritional status. We aimed to compare overall survival, body weight, and albumin changes between PEG and non-PEG groups. This retrospective cohort study was conducted at Songklanagarind Hospital, Southern Thailand, which included patients (aged ≥ 18 years) with head and neck cancer (HNC) diagnosed between 2007 and 2022. We used the nearest neighbor search to conduct the propensity score matching (PSM) in a 1:1 ratio. Of the 5024 eligible patients, 1604 (31.9%) underwent PEG. After PSM for age, sex, body mass index, type of HNC, time of diagnosis, stage, hemoglobin, albumin and total lymphocyte count, the final PEG and non-PEG groups each included 1,361 patients. The most common cancer type was stage 4 nasopharyngeal cancer. Patients with PEG showed a median survival time of 2.33 (95% confidence interval [CI] 2.15–2.65) years, which was significantly longer than that in the non-PEG group (1.04 [95% CI 0.97–1.10] years; p < 0.0001). The PSM results were similar, whereby patients with PEG showed a greater median survival time of 2.10 (95% CI 1.87–2.32) years compared to those without PEG (1.11 [95% CI 1.03–1.21] years; p < 0.0001). Patients who underwent PEG also showed significant reductions in the loss of body weight and albumin. Multivariable analysis demonstrated that PEG placement was a significant factor for improved 3-month survival (adjusted hazard ratio: 0.24, 95% CI 0.17–0.34). In patients with HNCs, PEG placement improved survival and resulted in a reduced loss of weight and albumin.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-25297-6.

To compare the peripherally inserted central catheter (PICC) and a new type of arm-port, the PICC-port, in patients with nasopharyngeal cancer in terms of complications and cost-effectiveness. A randomized controlled trial was conducted with a total of 126 patients. The patients were randomly assigned to the experimental group or the control group. The outcomes were observed from the day of placement until extubation. Demographic data, data related to catheter placement, and the placement effects were collected and analyzed using SPSS 29.0. Catheters were successfully inserted in 123 out of the 126 patients (61 in the experimental group and 62 in the control group). Compared with the control group, the experimental group had a lower incidence of complications after placement (21.3% vs 54.8%, p < 0.001). This included lower incidences of catheter dislodgement (0% vs 21.0%, p < 0.001), catheter occlusion (1.6% vs 12.9%, p = 0.032), wound oozing (4.9% vs 33.9%, p < 0.001), and medical adhesive-related skin injury (4.9% vs 14.9%, p = 0.025). Additionally, the severity of both wound oozing (p < 0.001) and medical adhesive-related skin injury (p = 0.014) was lower in the experimental group. Although the surgical cost was higher in the experimental group, the PICC-ports required less maintenance and the patients' quality of life coefficient was higher. When considering overall healthcare costs and health outcomes, the net benefits became equal between the two groups after 2.8 months. Beyond this point, the net benefits of the experimental group surpassed those of the control group, with the difference increasing as the dwelling time of the catheter increased. For patients with nasopharyngeal carcinoma requiring long-term treatment (duration >3 months), PICC-ports may be the preferred option compared to PICCs, particularly for those unable to undergo regular catheter maintenance or prioritizing quality of life.

This study aimed to assess metal exposure in the fingernails of men with nasopharyngeal cancer. Fingernail samples were analyzed using total reflection X-ray fluorescence technique. A multivariable logistic regression model was used to predict metal exposure levels, and Spearman correlations were used to identify variables associated with increased cancer risk. The results showed that the concentrations of 11 metals significantly differed between patients and healthy controls. Adjusted odds ratios (adj.OR) of metal exposure indicated significant positive associations with increased risk of cancer: Fe (adj.OR = 1.04), Cr (adj.OR = 3.70), Ni (adj.OR = 1.87), Cd (adj.OR = 2.93), As (adj.OR = 3.95), and Pb (adj.OR = 3.65). In contrast, significantly lower levels of Caand Zn were associated with increased risk of cancer: Ca (adj.OR = 0.9976) and Zn (adj.OR = 0.96). Among smoking patients, adj.ORs followed a similar trend but at higher levels, with an increasing risk for Fe (adj.OR = 1.02) < Mn (adj.OR = 1.96) < Cr (adj.OR = 2.31) < Ni (adj.OR = 2.72) < Cd (adj.OR = 5.57) < Pb (adj.OR = 5.61) < As (adj.OR = 6.96) and a decreasing risk for Zn (adj.OR = 0.93) > Ca(adj.OR = 0.9968). Furthermore, Spearman correlations showed that significantly higher levels of Ni and Cd and lower levels of Cu were associated with patients' living environments. Meanwhile, higher levels of Cr, Mn, Fe, Ni, As, and Pb and lower levels of Ca and Zn were significantly associated with smoking habits. In conclusion, significant alterations in fingernail metal concentrations were associated with an increased risk of nasopharyngeal cancer. Exposure to toxic metals, mainly through smoking and living environments, may contribute to disease development. These findings highlight the importance of public health strategies to mitigate metal-related cancer risks.

The burden of head and neck cancers (HNC) is a significant global health challenge, necessitating a comprehensive analysis of incidence and mortality trends. This study aimed to estimate the lastest disease burden and change trends of HNC in 2021 and examine trends from 1990 to 2021 using the Global Burden of Disease (GBD) Study 2021. We comprehensively focused on all HNC in GBD, including lip and oral cavity cancer (LOC), nasopharynx cancer (NPC), other pharynx cancer (OPC), and larynx cancer (LC), estimating incidence, prevalence, disability-adjusted life years (DALYs), and mortality rates, including age-standardized rates (ASR) and 95% uncertainty intervals (UIs) on global, regional, and national levels. Our results revealed that, in 2021, there were approximately 0.91 million new cases of HNC globally, representing significant increases from 1990, with specific increases in LOC (142.18%), NPC (55.89%), OPC (163.17%), and LC (60.48%). Additionally, around 0.5 million deaths were attributed to HNC. Notably, age-standardized incidence of nasopharyngeal cancer is increasing from 1990 to 2019, but decreasing from 2019 to 2021. Age-standardized mortality for LOC have declined among men but are rising among women between 1990 and 2021 (male: -6.61%, female: 7.95%). The burden of these HNC predominantly affected middle-aged and older populations. As the socio-demographic index rises, the incidence of LOC and OPC displayed a J-shaped relationship, but nasopharyngeal cancer, revealed a downward trend. The global burden of HNC grew steadily from 1990 to 2021, the variation in incidence and mortality rates across regions highlights the need for tailored prevention and treatment strategies to address the changing HNC landscape.

Abstract SPHK1 is a member of sphingosine kinases (SPHKs), and its abnormal expression has been correlated with poor prognosis and clinicopathological features in cancer patients. Growing evidence points to SPHK1's involvement in cellular resistance to chemotherapy, as well as its role in tumor progression, metastasis, and cancer cell survival. Mechanistically, SPHK1 catalyzes the formation of sphingosine-1-phosphate (S1P), a potent signaling lipid that promotes angiogenesis, metastasis, immune evasion, and survival through S1PR-mediated pathways. Reducing SPHK1 expression through genetic silencing or pharmacological inhibition has been shown in recent research to lessen drug resistance in cancer cells, suggesting that SPHK1 is a potential target for anticancer therapies. For example, SPHK1 inhibitors and anti-S1P monoclonal antibodies could enhance the efficacy of doxorubicin in breast cancer, docetaxel in prostate cancer, and gemcitabine in pancreatic cancer. This review aims to provide a detailed description of the structure and molecular mechanisms that regulate SPHK1. Additionally, we review the interaction between SPHK1 signaling and drug resistance mechanisms separately in various cancers, including breast, gynecological, esophageal, nasopharyngeal, lung, liver, pancreatic, gastric, and colorectal cancers. Finally, we discuss the prospects and challenges of SPHK1 regulation as a therapeutic strategy in resistant cancer therapy. We anticipate that our review will offer valuable insights and provide a foundation for future research. Graphical Abstract

Anti-synthetase syndrome (AS), also referred to as Anti-Jo1 syndrome or AS syndrome is an inflammatory myopathy. AS is an autoimmune condition characterized by the presence of autoantibodies against aminoacyl transfer RNA synthetases (anti-ARS) that may manifest with a variety of symptoms and clinical characteristics. [1] The diagnosis and management of AS syndrome are challenging. A diagnosis of AS syndrome may be suspected based on certain specific characteristics and after ruling out other potential diagnoses. This patient was diagnosed with nasopharyngeal cancer during the diagnostic workup for AS syndrome. This case of AS syndrome is discussed below in light of published literature, as a paraneoplastic AS syndrome secondary to nasopharyngeal cancer has never been reported before.

BackgroundThis study aimed to assess temporal trends, health inequities and potential improvements in the burden of head and neck cancer (HNC) in middle-aged and older adults between 1990 and 2021, focusing on three major subtypes: larynx, nasopharynx, and lip/oral cavity cancers.MethodsA secondary analysis of the Global Burden of Disease Study (GBD) 2021 was performed, using age-standardised incidence rates (ASIR) and age-standardised disability-adjusted life years (ASDR) to quantify the burden of HNC. The average annual percent change was calculated to analyzed trends. The slope index of inequality (SII) and the concentration index quantified health inequities. Frontier analysis identified regions with potential for improvement.ResultIn 2021, there were approximately 650,205 new cases of overall HNC globally, resulting in 9,621,610 DALYs, with ASIR and ASDR both declining since 1990. ASIR exhibited a decrease for laryngeal and nasopharyngeal cancers, in contrast to an increase for lip and oral cavity cancers. ASDR decreased across all cancer types. The SII showed a notable shift in ASDR from countries with higher socio-demographic indices (SDI) in 1990 to those with lower SDI countries by 2021. Meantime, the concentration index revealed a worsening inequality in lower SDI countries. Frontier analyses across 204 countries and territories indicated that certain high SDI countries could effectively reduce ASDR for HNCs.ConclusionThe global burden of HNCs shown considerable regional disparities. Health inequalities have persisted, with lower SDI regions bearing a heavier burden, particularly in laryngeal and lip/oral cavity cancers. Developing tailored national cancer control plans and enhancing international medical cooperation are essential to reduce HNC burden and promote equitable health outcomes.

Epstein-Barr virus (EBV) infection is closely associated with the occurrence of nasopharyngeal carcinoma (NPC). The latent membrane protein 1 (LMP1) gene, known for its high heterogeneity, plays a crucial role in the oncogenic potential of EBV associated NPC (EBVaNPC). This study aimed to integrate algorithm with experimental validation to contribute valuable insights into the early detection and risk assessment of EBVaNPC, and investigate the functional significance of LMP1 key mutation. The LMP1 region in clinical EBV-positive subjects was sequenced with amplicon-based next-generation sequencing. An automatic viral sequence feature extraction (ViSFE) approach was developed. Biological implications of predicted key mutation on tumor cell biological behaviors were investigated through qRT-PCR, EdU analysis, transwell invasion assay, RNA sequencing and gene ontology fingerprint (GOF) method. Validation results demonstrate the feasibility of ViSFE applied to nucleotide data of varying lengths. Our study identified H101R mutation in LMP1 as a top feature, confirmed by proliferation and invasion experiments. By integrating EBVaNPC GOF and RNA sequencing data, the differentially expressed genes linked to the H101R mutation were primarily involved in immune regulation processes. Both approaches indicated a notable association between FOXP3-T cell anergy and WNT7A-stem cell population maintenance in HNE-1MUT−LMP1. This study offers a new strategy for high-risk NPC identification in EBV infected subjects. A tool for ViSFE is available at: http://www.biomedinfo.cn/ViSFE/index.html.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12985-025-02973-7.