局部复发性鼻咽癌的临床病理特征(附240例分析)  

Clinicopathological characteristics of locally recurrent nasopharyngeal carcinoma (An analysis of 240 cases)

作　　者：罗容珍[1] 梁小曼[1] 宗永生[2] 钟碧玲[2] 吴秋良[1] 何洁华[1] 林素暇[1] 

机构地区：[1]中山大学附属肿瘤医院病理科,广东广州510060 [2]中山大学中山医学院病理学教研室,广东广州510089

出　　处：《实用肿瘤杂志》2004年第2期124-126,共3页Journal of Practical Oncology

基　　金：国家自然科学基金(编号 :39730 2 0 0 - );中山医科大学"2 11"工程基金(编号 :980 4 8)资助

摘　　要：目的　探讨经放疗后局部复发的鼻咽癌临床和病理组织学特征。方法　收集确诊为鼻咽癌患者 2 6 10例病理资料 ,复查病历记录及活检切片。结果　 2 4 0例局部复发性鼻咽癌占 9.2 % ( 2 4 0 / 2 6 10 ) ,男女比率为 5 .32∶1( 2 0 2 / 38) ,较 2 370例未经治疗的鼻咽癌者男女之比 ( 2 .98∶ 1,1775 / 5 95 )为高。在有确诊到复发间隔记录的 2 37例中 ,平均间隔期为 3年 10个月。 <1年内复发 4 8例 ( 2 0 .3% ) ,1～ <5年内复发 14 1例 ( 5 9.5 % ) ,5～ <10年内复发 2 9例 ( 12 .2 % ) ,>10年才复发 19例 ( 8.0 % )。与 2 370例未经治疗的鼻咽癌相比 ,角化性鳞状细胞癌在局部复发性鼻咽癌中所占的百分率以及分化型非角化性癌在非角化性癌中所占的百分率分别为 10 .0 %与 2 .3%和 18.7%与 8.9% ,均有显著增高 ( P<0 .0 0 1)。结论　 ( 1)鼻咽癌经放疗后局部复发多发生在 5年内。 ( 2 )相当一部分局部复发性鼻咽癌在局部复发时 ,癌细胞的鳞化程度要较原发时为高。Objective To investigate the clinicopathological characteristics of locally recurrent nasopharyngeal carcinoma (LRNPC) after radiotherapy. Methods 2 610 cases of consecutive NPC biopsies were reviewed and 240 cases had local recurrence (9.1%) after radiotherapy. The clinical data and histopathology of these recurrent cases were reviewed. Results The ratio of male to female in 240 LRNPCs (202/38, 5.32∶1) was significantly higher than that in 2 370 primary untreated NPCs ( 1 775 /595,2.98∶1)( P <0.05). Among the 237 LRNPC patients,whose data were available, the average interval of recurrence was 3 years and 10 months. Forty eight LRNPC patients (20.3%) developed recurrence within 1 year, 141 patients (59.5%) 1~<5 year, 29 patients (12.2%) 5~<10 year and 19 patients (8.0%) more than 10 years. The percentage of keratinizing squamous cell carcinoma in LRNPCs (10.0%) and the percentage of differentiated non keratinizing carcinoma in non keratinizing carcinoma (18.7%) were both significantly higher ( P <0.001) as compared with those in primary untreated NPCs (2.3% and 8.9%, respectively). Conclusion (1)The recurrence of NPC after radiotherapy mostly developed within 5 year. (2)A considerable number of LRNPCs has higher squamous differentiation grade than those of primary NPCs.

关 键 词：局部复发性鼻咽癌 病理组织 治疗 鼻咽肿瘤 病理学 放射疗法 

分 类 号：R739.63[医药卫生—肿瘤]