鼻咽镜和MRI及超声波引导穿刺检查在头颈部原发肿瘤诊断中的联合应用  

Nasal endoscope, MRI, and ultrasound-guided fine needle aspiration in the diagnosis of primary head and neck tumor

作　　者：张有望[1] 黄雅芳[2] 吴永如[1] 孔琳[1] 黄爽[1] 胡超苏[1] 

机构地区：[1]复旦大学附属肿瘤医院放疗科 复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学附属肿瘤医院超声科,上海200032

出　　处：《中华耳鼻咽喉头颈外科杂志》2014年第3期223-226,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 探讨多种检查方法在头颈部原发肿瘤诊断中的应用价值.方法 回顾性分析196例未确诊的头颈部肿物初诊患者,所有患者在完成详细的病史询问、仔细的临床体格检查及影像学检查后,对疑为肿瘤部位行活体组织病理检查（简称活检）或穿刺细胞学检查.结果 196例患者中除4例口咽周围肿块的患者行直接穿刺外,余192例均在超声波引导下穿刺.171例（87.2％）患者检出肿瘤细胞：其中通过原发肿瘤部位（鼻咽部）活检确诊31例,通过穿刺细胞学检查确诊106例,通过原发肿瘤部位（鼻咽部）活检和穿刺细胞学检查均确诊34例.140例（71.4％）穿刺细胞学检查见肿瘤细胞,咽后淋巴结、咽旁间隙和口咽周围肿块的肿瘤细胞检出率分别为71.1％ （123/173）,66.7％ （10/15）,87.5％ （7/8）.在获取病理细胞学诊断过程中无一例发生严重并发症.结论 间接鼻咽镜活检、MRI及超声波引导穿刺细胞学检查的相互结合,对肿瘤患者的早期诊断、早期治疗具有重要的临床价值.Objective To investigate the role of muhiple diagnostic methods in the head and neck tumor.Methods One hundred and ninety-six patients without definite pathological diagnosis referred from other hospitals were included in this retrospective study.All patients had a biopsy or fine needle aspiration （FNA） of the suspected region after detailed medical history enquiry,physical examination and imaging examination.Results All patients had ultrasound-guided FNA except 4 patients who had direct FNA.One hundred and seventy-one patients （87.2%） were confirmed to have tumor cells by pathological diagnosis,among them,31 patients by biopsy of primary region alone,106 by FNA,and 34 by both.The positive rate of FNA was 71.4% （140/196） for the whole group,71.1% （123/173）,66.7% （10/15） and 87.5% （7/8） for retropharyngeal lymph node subgroup,parapharyngeal space subgroup and oropharynx subgroup.Conclusion The combined use of endoscope,MRI,and ultrasound-guided FNA is useful for the diagnosis of head and neck tumor.

关 键 词：头颈部肿瘤 淋巴转移 喉镜检查 活组织检查 针吸 内窥镜超声引导细针针吸活检 磁共振成像 

分 类 号：R739.91[医药卫生—肿瘤]