PTGS2 and neoplasm: The current concept of cancer related inflammation is that there are two pathways: an intrinsic pathway, where oncogenes and tumour suppressor genes activate the expression of inflammation mediated programmers; and an extrinsic pathway where chronic inflammation leads to carcinogenesis.6, 7, 8 With regard to inflammation in NPC some work has been done that shows in vitro that COX-2 is involved in the multistep process of NPC carcinogenesis and the Cyclo-Oxygenase 2 inhibitor Celecoxib may play a role in inhibition of invasion and migration of NPC cells.9