鼻咽癌颈部淋巴结转移的分布特征分析  

Metastasis pattern of cervical lymph nodes metastasis in nasopharyngeal carcinoma

作　　者：郭笑寒[1] 屈先凤 田兴仓[2] 李文玲[2] 蒲艳军 穆丽莎[2] 朱力[2] 

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]宁夏医科大学总医院放射科,宁夏银川750004

出　　处：《中国医学影像技术》2016年第2期209-213,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨鼻咽癌颈部淋巴结转移分布的MRI特点。方法对46例临床确诊为鼻咽癌的患者行常规MR平扫及增强扫描,根据2013版ESTRO推荐的颈部淋巴结分区标准分析转移淋巴结情况。结果 46例鼻咽癌患者中41例有淋巴结转移,主要转移区域为Ⅱ区及Ⅶ区,分别为70.73%(29/41)和65.85%(27/41)。原发肿瘤不同T分期的淋巴结转移率分别为T1期83.33%(5/6)、T2期100%(6/6)、T3期93.33%(14/15)、T4期84.21%(16/19),差异无统计学意义(χ2=2.349,P>0.05)。原发灶同时累及鼻咽侧壁及顶后壁16例,局限于顶后壁17例,局限于侧壁13例,不同部位的原发灶淋巴结转移率差异无统计学意义(χ2=1.784,P>0.05)。淋巴结跳跃转移率为4.35%(2/46)。结论鼻咽癌颈部转移淋巴结以Ⅱ区及Ⅶ区多见,均为鼻咽癌的前哨淋巴结。鼻咽癌颈部淋巴结转移的分布与T分期及原发灶部位无关系。鼻咽癌跳跃转移少见。Objective To explore the distribution patterns of metastatic cervical lymph nodes in nasopharyngeal carcinoma （NPC） patients with MRI. Methods Totally 46 NPC patients confirmed by histopathologically or nasopharyngoscopy un- derwent MRI. The distribution of metastatic cervical lymph nodes were observed according to the ESTRO 2013 update guidelines. Results Forty-one of 46 patients had lymph nodes metastasis. The lymph nodes metastasis were mainly distributed in Ⅱ area 70.73% （29/41） and Ⅶ area 65.85% （27/41）. The incidence of lymph nodes metastasis in different T stages of the primary tumor respectively were 83. 330/00 （5/6） in T1 stage, 100% （6/6） in T2 stage, 93.33% （14/15） in T3 stage and 84.21% （16/19） in T4 stage （P〉0.05）. Sixteen cases of the primary lesion involved the lateral wall and posterior wall of nasopharynx at the same time, 17 cases of primary lesion were restricted to the posterior wall and 13 cases were restricted to the lateral wall, there was no statistically significant difference in the rate of lymph nodes metastasis among different sites of primary tumor （χ2= 1. 784, P〉0. 05）. The incidence of skip lymph nodes metastasis was 4. 35 % （2/46）. Conclusion The area Ⅱ and Ⅶ are the most frequently regions of cervical lymph node metastasis in NPC, these are both the first echo node. There is no relationship between the distribution of cervical lymph node metastasis and T staging of NPC, the primary site. Skip lymph node metastasis rate is very low.

关 键 词：鼻咽肿瘤 淋巴结 磁共振成像 

分 类 号：R739.6[医药卫生—肿瘤] R445.2[医药卫生—临床医学]