不明原发灶颈部转移癌的诊断和治疗

不明原发灶颈部转移癌原发灶的检出与否直接影响患者的生存率和生活质量。目前颈部转移癌原发灶的检测以传统检查方法为主,近年来全内镜检查随机活检、氟脱氧葡萄糖正电子发射断层摄影术、激光介导荧光内镜和基因检测等技术提高了原发灶的检出率。根据淋巴结转移部位、病理类型、N分期等对不明原发灶颈部转移癌制订合理的治疗方案。现重点对不明原发灶颈部转移癌的传统和新近发展的诊治方法进行综述,以期对临床工作有所帮助。

Diagnosis and Treatment of Cervical Metastatic Carcinoma of Unknown Origin

The detection of primary lesions is critical for the long-term survival and quality of life in patients with cervical metastatic carcinomas of unknown origin.Its detection mainly depends on the conventional methods available.The recent emergence of random endoscopic biopsy,fluorodeoxyglucose positron emission tomography,laser-induced fluorescence endoscopy and gene assay improves the detection rate of the primary lesions.A rational regimen derives from the evaluation of the lymph node involvement,pathological type and N staging.This review compares the conventional and recently developed diagnostic and therapeutic modalities,in aiming to improve the clinical outcomes.