不同病理类型鼻咽癌临床特征和预后分析  

Clinical manifestations and prognosis of nasopharyngeal carcinoma of different pathological types

作　　者：黄少华[1] 陈贤明[2] 谢九根[3] 

机构地区：[1]福建医科大学福总临床医学院,福建福州350025 [2]南京军区福州总医院耳鼻咽喉头颈外科,福建福州350025 [3]吉安市中心人民医院,江西吉安343000

出　　处：《中国耳鼻咽喉颅底外科杂志》2015年第5期383-385,389,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的分析不同病理类型鼻咽癌在性别、T分级、N分级、颈部淋巴结转移、复发、远处转移及血清EBV-Ig A阳性率之间的差异。方法回顾性分析2006年1月1日~2012年9月1日就诊于南京军区福州总医院的1 286例鼻咽癌患者的病理类型、血清EBV-Ig A检验结果、年龄、性别、T分级、N分级、治疗方式、复发、远处转移等临床资料,并随访其生存状况,分析不同病理类型鼻咽癌之间差异。结果列入研究的1 286例鼻咽癌中,WHO-Ⅰ型鼻咽癌有76例,WHO-Ⅱ/Ⅲ型有1210例。血清EBV-Ig A抗体阳性率分别为74.5%和85.4%,差异具有统计学意义（P=0.036）。WHO-Ⅰ型颈淋巴结转移77.6%,而WHO-Ⅱ/Ⅲ型颈淋巴结转移87.0%,两者比较差异具有统计学意义（P=0.015）。WHO-I型和WHO-Ⅱ/Ⅲ型鼻咽癌在性别、N分级、复发、远处转移方面无明显差异（P〉0.05）。WHO-Ⅰ型和WHO-Ⅱ/Ⅲ型鼻咽癌患者1、3、5年总生存率分别为84%、67%、67%和85%、72%、65%,差异无统计学意义（P〉0.05）。结论不同病理类型鼻咽癌在T分级、血清EBV-Ig A抗体阳性率、颈淋巴结转移率方面有差异,而性别、N分级、复发、远处转移方面无明显差异,1、3、5年总生存率无明显差异。Objective To investigate the differences of patients＇ gender,T stage,N stage,recurrence,metastasis and positive rate of serum EBV-Ig A among patients with nasopharyngeal carcinoma（ NPC） of different pathological types,and then to further explore the relationship between pathological type and survival rate. Methods Clinical data of 1 286 NPC patients receiving treatment in Fuzhou General Hospital of Nanjing Military Command from Jan 2006 to Sep 2012 were studied retrospectively. The data included pathological type,result of serum EBV-Ig A,patients＇ gender and age,T stage,N stage,treatment method,recurrence and metastasis,and survival rate. Their differences were analyzed. Results 1 Of the 1 286 cases included in the study,according to the pathological classification criterion of NPC from World Health Organization（ WHO）,-76 cases were typeⅠ（ WHO-Ⅰ）,1210 were type Ⅱ / Ⅲ（ WHO-Ⅱ / Ⅲ）. Their positive rates of EBV-Ig A were 74. 5% and 85. 4% with a statistically significant difference（ P〈0. 05）. Their difference in T stage was also statistically significant（ P〈0. 05）. 2 The lymph node metastatic rates of WHO-Ⅰ and WHO-Ⅱ / Ⅲ were 77. 6%（ 59 /76） and 87. 0%（ 1 057 /1210）,and the difference was statistically significant（ P〈0. 05）. 3The differences of patients＇ gender,N stage,recurrence,systemic metastasis between WHO-Ⅰ and WHO-Ⅱ / Ⅲ were all statistically insignificant（ P〉0. 05）. 4The overall 1-,3- and 5-years survival rates of WHO-Ⅰ and WHO-Ⅱ / Ⅲ were 84%,67%,67% and 85%,72%,65%,respectively. Their differences were all statistical insignificant（ P〉0. 05）. Conclusion Nasopharyngeal carcinoma of different pathological types differs in positive rate of serum EBV-Ig A,T stage and lymph node metastatic rate,while their differences in gender,N stage,recurrence,systemic metastasis,and survival rate were statistically insignificant.

关 键 词：鼻咽癌 病理类型 临床表现 预后 

分 类 号：R739.63[医药卫生—肿瘤]