摘要
目的 探讨B超检查在鼻咽癌颈淋巴结转移灶检查中的应用价值。方法 对 4 5 1例初发和复发的鼻咽癌病人在放疗前、后均进行颈淋巴结临床触诊和B超检查 ,记录颈淋巴结肿大的有无、大小等情况 ,并进行比较分析。结果 392例初发病人 ,经B超检查后导致临床分期变化的有 14例 (3.6 % )。触诊双侧颈N0 和单侧颈N0 的假阴性率分别为 2 8.2 %和 2 5 .5 %。鼻咽和颈同时复发的 14例病人中 ,触诊漏诊率为 2 1.4 %。单纯颈复发的32例病人中 ,触诊误诊率为 12 .5 %。在颈淋巴结融合成团的 33例病人中 ,触诊误诊率为 5 1.5 %。在超重或肥胖的31例病人中 ,颈部最大淋巴结的大小触诊与B超检查相比较 ,结果有统计学意义 (P <0 .0 1) ;放疗结束时 ,颈淋巴结全消与残留的情况 ,触诊与B超检查相比较亦有统计学意义 (P <0 .0 0 1)。结论 B超扫描较临床触诊检查鼻咽癌病人颈淋巴结准确性更高 ,对临床分期、指导治疗和判断预后有一定的价值。
Objective To explore the clinical evaluation of ultrasonography for cervical lymph nodes metastasis of nasopharyngeal carcinoma. Methods The cervical lymph nodes in 451 patients of incipient and recurrent nasopharyngeal carcinoma were given detailed examination with ultrasonography and manual palpation respectively before and after radiotherapy. Cervical lymph nodes and the size were registered. Results Of the 392 incipient patients, 14 cases ( 3.6%) were found by ultrasonography that the Clinical Staging had been changed. The false negative rates of double side neck N 0 and single side neck N 0 by manual palpation were 28.2% and 25.5% respectively. Among the 14 patients that recurred in nasopharynx and neck at the same time, the missed detection rate of manual palpation was 21.4%. Among the 32 patients that recurred only in neck, the missed detection rate of manual palpation was 12.5%. Among the 33 patients whose cervical lymph nodes agglomerated, the missed detection rate of manual palpation was 51.5%. There was significant difference in size of lymph nodes measured by manual palpation and by ultrasonography among the 31 patients who were fat or overweight (P< 0.01), and the remains at the end of therapy were measured by the two means showing high significantly difference (P< 0.001). Conclusion Ultrasonography was more accurate than manual palpation in measuring the lymph nodes of the neck of nasopharyngeal carcinoma, It would be some valuable to clinical staging, guiding treatment and predicting curative effect.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2004年第6期358-360,共3页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
鼻咽肿瘤/超声检查
淋巴转移
鼻咽肿瘤/病理学
Nasopharyngeal neoplasms/ultrasonography
Lymphatic metastasis
Nasopheryneal neoplasms/nathol
