珠海市住院鼻咽癌患者626例临床首发症状调查分析  

Clinical initial presentation research and analysis of 626 hospitalized patients with nasopharyngeal carcinoma in Zhuhai City

作　　者：徐建慧[1] 陈新野[2] 王思阳[3] 梁子彬[3] 廖伟[2] 洪海裕[2] 

机构地区：[1]中山市人民医院耳鼻咽喉头颈外科,广东中山528403 [2]中山大学附属第五医院耳鼻咽喉科,广东珠海519000 [3]中山大学附属第五医院放疗科,广东珠海519000

出　　处：《中华肿瘤防治杂志》2012年第24期1845-1847,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:通过对鼻咽癌首次住院接受治疗患者的患病情况调查,了解鼻咽癌在珠海地区的临床患病特点,并与既往资料比较,为早期诊断提供依据。方法:回顾性调查分析2003-03-2011-03中山大学附属第五医院首次住院的626例鼻咽癌患者的病例资料。按预先设计的调查表,收集患者的首发症状、淋巴结肿大转移及颅神经侵犯等情况,并进行统计分析。结果:患者首发症状主要为颈部包块、涕血、耳鸣等症状,其中颈部包块为最典型的首发症状,占27.8%,涕血占23.0%,耳鸣占17.7%。颈部淋巴结转移423例(67.6%);在淋巴结转移的患者中,单侧转移314例(74.2%),双侧转移109例(25.8%),颈淋巴结以Ⅱ区转移最多见(90.0%),跳跃性转移率为4.7%。发生颅神经侵犯共103例(16.4%),以第Ⅴ、Ⅵ和Ⅻ对颅神经受累率较高,分别占5.4%、5.1%和3.7%。结论:颈部包块是鼻咽癌的典型首发症状,临床确诊时多在Ⅲ期;在珠海对当地基本人群进行健康宣教及体检普查,对于早期发现鼻咽癌有着十分重要的意义。OBJECTIVE：According to clinical data of patients with nasopharyngeal carcinoma,to analyse clinical fea- tures of Zhuhai City,and compared with previous data to provide a preference for prevention and treatment of nasopharyn- geal carcinoma. METHODS：Clinical data of 626 patients who were diagnosed as nasopharyngeal carcinoma in fifth affiliated hospital of Sun Yat-sen university from March 2003 to March 2011 was collected and symptoms, node distribution and cra- nial never paralysis were analyzed in this study according to designed table. RESULTS： The most common initial symptom was neck mass with an incidence of 27.8% ,followed by nasal bleeding（23.0%） and otological symptoms（17.7% ）. Of 626 patients 423（67.6%） had cervical lymphadenopathy at presentation. Of the 423 neck positive cases, the node involvement was unilateral in 74.2% patients and bilateral in 25.8%. The level Ⅱ was the most frequently involved area（90.0%）, with the incidence of skip metastases was 4.7%. The cranial never involvement was 16.4% and the involvement for crani- al neverV , VI and Ⅻ was 5.4% ,5.1% and 3.7% respectively. CONCLUSIONS：Nasal symptoms is the most common ini- tial manifestation,and clinical diognosis is most in stage Ⅲ. It is significant for early diagnosis to carry out medical exami- nation for healthy population in Zhuhai.

关 键 词：鼻咽肿瘤 患病率 体征和症状 呼吸系统 早期诊断 

分 类 号：R739.63[医药卫生—肿瘤]