纤维鼻咽镜对上颈部疑似恶性肿块的诊断价值

目的：探讨纤维鼻咽镜在上颈部疑似恶性肿块诊断中的意义。方法：回顾分析1985～2005年，结合纤维鼻咽镜检查诊治的上颈部非甲状腺非涎腺疑似恶性肿块362例，纤维鼻咽镜一次不能确诊原发灶的则行肿块切取活检。结果：362例疑似恶性肿块经一次纤维鼻咽镜检查活检确诊原发灶215例占59％。结合手术最终检出恶性肿块269例占74．3％，其中原发恶性肿瘤（恶性淋巴瘤）43例占16％，转移性肿瘤226例占84％；良性肿块93例占25．7％，其中淋巴结结核42例占45％，淋巴结反应性增生51例占55％。结论：上颈部肿块多为恶性肿瘤的淋巴结转移灶，及时发现原发灶并据此制定相应的治疗方案对疾病的治疗具有极其重要的意义，而纤维鼻咽镜检查对颈部转移性肿块原发灶的发现和确诊具有重要的作用。

Diagnostic Value of Nasopharygo-fiberscope for the Dubious Malignant Masses in Upperside Cervix

Objective:To discuss the importance of nasopharygo-fiberscope in diagnosing the dubious malignant masses in upperside cervix.Methods:We reviewed and analyzed 362 cases of possibly malignant cervical masses neither tumors of thyroid gland nor tumors of salivary gland from 1985 to 2005,which were diagnosed by nasopharygo-fiberscope in our department.The definite diagnosis of some cases,whose primary locations couldn't be found one time by nasopharygo-fiberscope,were detected by tumor biopsy.Results:Out of 362 cases,215 cases accounting for 59% of primary focuses were located one time by nasopharygo-fiberscope.Through surgical examination,we finally found 269 cases accounting for 74.3% were malignant tumors.Out of 269 cases,43 cases accounting for 16% were lymphomas,226 cases accounting for 84% were metastases tumors,and 93 cases accounting for 25.7% were benign masses.In benign cases,42 cases were cervical scrofula,51 cases were reactive proliferation of cervical lymph.Conclusion:Most of the cervical masses were metastases malignant tumors,timely detect of the primary location and establish of corresponding therapy are critical to the freafment of the diseases.Nasopharygo-fiberscope is very important to locate primary location and diagnose the cervical masses which are metastasis malignant tumors.