鼻咽癌颈淋巴结活检对远处转移的影响  

Discussion on biopsy of cervical lymph nodes and distant metastasis in nasopharyngeal carcinoma

作　　者：张典刚[1] 吴冉[1] 王若峥[1] 

机构地区：[1]新疆医科大学附属肿瘤医院放疗科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2013年第1期7-10,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区科技国际合作项目(201141138);乌鲁木齐市人才工程重点培养对象专项基金(P112310001)

摘　　要：目的探讨鼻咽癌颈淋巴结活检对患者治疗后远处转移的影响。方法选择2008年3月-2009年6月在新疆医科大学附属肿瘤医院放疗科治疗的原发鼻咽癌患者115例,对接受放射治疗并完成根治剂量,疗前、疗中无远处转移证据,随访资料完整且N1～N3期97例患者,根据鼻咽部活检前是否行颈部淋巴结活检分为颈部活检组(25例)和鼻咽活检组(72例),比较两组远处转移情况及影响鼻咽癌远处转移的独立预后因素。结果颈部活检组3年远处转移率32.00%,鼻咽活检组3年远处转移率为26.39%(P>0.05);颈部活检组和鼻咽活检组3年累积无远处转移生存率在分别为59.50%和67.80%(P=0.616);3年总生存率分别为61.20%和71.8%(P=0.966);多因素分析发现鼻咽癌N分期是无远处转移生存率的独立预后因素。结论鼻咽癌颈部活检后尽快开始化疗且颈部采用调强放疗技术可以取得与鼻咽活检组相同的疗效。Objective To investigate the influence on distant metastasis of cervical lymph nodes biopsy in nasopharyngeal carcinoma （NPC）. Methods One hundred and eleven cases in-patients on primary NPC were defined by histopathology at our cancer center from March 2008 to June 2009. Among them, 97 patients with radical radiothera N3, were divided into biopsypy of and completely followed up informations, which clinical tages were N cervical lymph biopsy of nasopharynx group （72 cases）. All of nodes which group had no （25 cases, before biopsy of na evidence of distant metastasis sopharynx） and before and during the treatment. Results The 3-year distant metastasis free survival rates, with and without biopsy of cervical lymph nodes, were 59. 50% and 67.80%, respectively （P=0. 616）, the 3-year overall survival rates were 61.20% and 71.8% （P =0. 966）, the distant metastasis rates were 32.00% and 26.39%, re spectively （P 〉005）. Multivariate analysis showed that only N staging were significant independent pre dictors for distant metastasis-free survival rate. Conclusion Biopsy of cervical lymph nodes group can a chieve the same therapeutic outcome with biopsy of nasopharynx group by using intensity modulated radia tion therapy for neck field and giving chemotherapy as soon as possible in NPC.

关 键 词：鼻咽肿瘤 放射疗法 颈淋巴结活检 肿瘤转移 

分 类 号：R739.63[医药卫生—肿瘤]