An important challenge in nasopharyngeal carcinoma (NPC) research is to develop 
effective predictors of tumor recurrence following treatment to determine 
whether immediate adjuvant therapy is necessary. We retrospectively analyzed 
archived specimens collected from 45 patients with paired samples of primary NPC 
(pNPC) and recurrent NPC (rNPC). Clinical samples were collected from the Cancer 
Center Databases of the First People's Hospital of Foshan and Shantou Central 
Hospital (affiliates of Sun Yat-Sen University) between 2001 and 2012. 
Expression levels of phosphor-Stat3 (p-Stat3), signalosome complex subunit 5 
(Jab1/Csn5), Akt1, C/EBP homologous protein (CHOP), Ki-67, and apoptosis were 
determined by immunohistochemistry in pNPC and rNPC samples from the same 
patients. Differences in these markers between the short-term interval to 
recurrence (ITR) group (ITR <18 months) and long-term ITR group (ITR ≥18 months) 
were further analyzed. In Cox's regression analysis, the ITR was significantly 
associated as an independent‑negative prognostic factor for overall survival 
(hazard ratio, 0.211; 95% confidence interval, 0.053-0.841; P=0.027). p-Stat3 
was increased in the short-term ITR group (ITR <18 months) and tended to be 
lower in the long-term ITR group (ITR ≥18 months). In the short-term ITR group, 
nuclear Akt expression was significantly increased in paired rNPC (P=0.028). In 
the long-term ITR group, the expression of nuclear Jab1/Csn5 (P=0.047) and 
assessment of apoptosis measured with TdT-mediated dUTP nick end‑labeling 
(TUNEL) (P=0.003) was significantly increased in paired rNPC. The results 
suggest that differences between short- and long-term ITR may predict outcome in 
rNPC. Furthermore, the overexpression of Jab1/Csn5 and Akt may contribute to the 
carcinogenesis of rNPC, and Akt seems to promote the progression of short-term 
ITR. Intra-individual changes of Jab1/Csn5, Akt, and TUNEL may help to identify 
short-term ITR.