鼻咽钡胶浆X线造影对鼻咽癌诊断和鉴别诊断的价值

本文总结５６例临床间接鼻咽镜检查阴性或可疑鼻咽新生物的患者，经造影检查均有阳性发现后作鼻咽活检确诊为鼻咽癌，从而归纳出鼻咽癌原发灶四点早期ｘ线征。另一组讨论了鼻咽癌与鼻咽部其他疾病（１４８例）的鉴别诊断。     

诊断鼻咽癌的新方法──鼻咽部拉网法

诊断鼻咽癌的新方法──鼻咽部拉网法山东济宁市第一人民医院李强，国桂松，黄建国，段友俊，宋其俊鼻咽部比较隐蔽，不易准确地采集到病变的脱落细胞，因此取材方法的研制关系着鼻咽癌涂片检查的阳性率。我科目行研制了一种鼻咽网，经对１５例鼻咽癌的鼻咽部拉网检查，阳...     

美蓝染色对鼻咽癌的诊断价值

纤维光束内镜下美蓝染色对鼻咽癌的诊断价值，目前看法尚不一致。自1991年2月～1996年4月，我们随机选择80例鼻咽癌患者行纤维鼻咽镜下美蓝染色，探讨其临床应用价值。材料和方法一、病例选择鼻咽癌35例，男性24例，女性11例，年龄为17～70岁，平均48岁。鼻咽粘膜炎症45例，慢性鼻咽炎42例，鼻咽结核3例。另选鼻咽癌40例行常规镜检，作为对照，全部病例均经病理诊断证实。二、方法令患者取仰卧垂头位，常规经鼻腔插入纤维鼻咽镜，观察粘膜病变情况，然后对病变、可疑病变和正常粘膜区进行染色。以5％碳酸氢钠sml～10ml和a一糜蛋白酶5ms冲洗…     

鼻咽癌的内镜诊断及鉴别诊断

纤维鼻咽镜检查下对鼻咽肿块进行病理组织活检是目前确诊鼻咽癌的标准手段,同时,纤维鼻咽镜对鼻咽癌的早期诊断及鉴别诊断以及其他鼻咽、鼻疾病的诊断均有较高的价值.全文就纤维鼻咽镜的操作、活检方式及对鼻咽癌诊断的意义、鉴别诊断作一综述.     

鼻咽穿刺负压抽吸细胞学检查对鼻咽癌诊断的价值

目的 探讨鼻咽穿刺负压抽吸细胞学检查对鼻咽癌诊断的临床价值.方法 对129例鼻咽病变患者用特制穿刺针进行穿刺负压抽吸细胞学检查,并将检查结果与病理组织学检查进行对照.结果 在确诊的87例鼻咽癌患者中,细胞学检查阳性80例.结论 鼻咽穿刺负压抽吸细胞学检查对鼻咽癌的诊断具有一定价值.     

外周血和鼻咽组织EB病毒DNA检测对鼻咽癌诊断和防控的临床观察

目的探讨外周血和鼻咽组织EB病毒DNA检测对鼻咽癌诊断和防控的临床意义以及鼻咽腔冲洗对防控鼻咽癌的价值。方法选取2010年12月至2012年4月55例鼻咽癌患者为观察组,抽取同期55例健康者为对照组,采用EB病毒DNA PCR荧光定量检测技术检测外周血和鼻咽组织EB病毒DNA,比较鼻咽癌患者与健康者外周血和鼻咽组织EB病毒DNA检测结果。对另外1组67例EB病毒抗体阳性而鼻咽活检结果为阴性者进行鼻咽腔冲洗,比较治疗前、后EB病毒抗体检测结果。结果观察组患者外周血、鼻咽组织中EB病毒DNA阳性检出率均高于对照组健康者,差异均有统计学意义(均P<0.01)。经鼻咽腔冲洗治疗后,EB病毒抗体阳性者检测转阴率为19.4%,患者临床症状明显改善。结论鼻咽组织EB病毒DNA检测有助于鼻咽癌的临床诊断,对EB病毒抗体阳性者进行鼻咽腔冲洗治疗对于鼻咽癌的防控具有重要意义。     

TSGF对鼻咽癌的诊断价值

目的 探讨恶性肿瘤特异性生长因子(TSGF)在鼻咽癌诊断中的价值。方法 对经鼻咽部活检确诊鼻咽癌，未经治疗的233例病人测定TSGF值。结果 全组阳性率52％(12l／233)。结论 TSGF对鼻咽癌的诊断有比较高的敏感性，操作简单快速，是诊断鼻咽癌的又一种检测方法。     

基于鼻咽部黏膜细胞稳定性FH检测的联合检测手段在鼻咽癌早期诊断中的应用

目的探讨鼻咽部黏膜细胞稳定性FH检测、电子鼻咽镜、EB病毒血清学检查3种方法单独及联合检查在鼻咽癌诊断中的价值。方法采用鼻咽部黏膜细胞稳定性FH检测、电子鼻咽镜检查、EB病毒VCA-IgA检测3种检查方法对2017年1月至2018年6月在长沙市第一医院耳鼻喉科就诊的303例疑似鼻咽癌患者进行检查,比较3种方法单独及联合检测诊断鼻咽癌的敏感性以及特异性。结果 303例临床症状可疑鼻咽癌患者经鼻咽病理活检确诊鼻咽癌189例。鼻咽部黏膜细胞稳定性FH检测、EB病毒VCA-IgA检测以及电子鼻咽镜检查单独运用诊断鼻咽癌的敏感性分别为89.9%、84.7%、83.1%,特异性分别为80.7%、77.2%、81.6%。任意两种方法联合检查以鼻咽部黏膜细胞稳定性FH检测联合EB病毒VCA-IgA检测敏感性最高(83.1%);鼻咽部黏膜细胞稳定性FH检测联合电子鼻咽镜检查特异性最高(93.9%)。三者联合检查的敏感性显著降低(77.2%),但特异性升高(93.9%)。结论鼻咽部黏膜细胞稳定性FH检测联合EB病毒血清学检测的方法诊断早期鼻咽癌具有较高的敏感性和特异性,方法简单可行,适于临床推广应用。     

鼻咽中药冲洗对鼻咽癌放疗并发症防治的作用

 目的 探讨鼻咽中药冲洗对鼻咽癌放疗并发症的防治作用。方法 122例鼻咽癌患者分为鼻咽中药治疗组60例和对照组62例，治疗组应用中药鼻咽冲洗，经鼻腔、鼻咽、口咽吐出，对照组用生理盐水冲洗。结果 治疗组较对照组口腔黏膜反应、口臭、鼻窦炎、鼻腔粘连减少，有明显效果（P＜0.01）。结论 鼻咽中药冲洗可有效减少鼻咽癌放疗反应及并发症，提高生活质量。     

电子鼻咽镜下不同活检方法对早期诊断鼻咽癌的临床价值

目的探讨电子鼻咽镜下不同活检方法对早期诊断鼻咽癌的临床价值。方法将166例疑是鼻咽癌患者随机分为2组。对照组83例,电子鼻咽镜下采用配套活检钳经活检道行鼻咽部活检;手术组83例,电子鼻咽镜下采用常规活检钳经口腔行鼻咽部活检术。结果活检准确率以1次钳取组织即取得阳性结果为标准计算,对照组活检准确率79．5％,手术组活检准确率98．8％,2组比较,手术组活检准确率明显过于对照组（P〈0．05）。结论电子鼻咽镜下采用常规活检钳经口腔行鼻咽部活栓术,能检查鼻咽部各个部位并钳取各个部位的组织,对深层病变组织钳取更有优势,有利于早期诊断鼻咽癌。     

Cancer susceptibility in nasopharyngeal carcinoma families--a population-based cohort study

Undifferentiated nasopharyngeal carcinoma is a result of environmental factors, in particular EBV infection, affecting genetically susceptible individuals. The familial risk of nasopharyngeal carcinoma is among the highest of any malignancy. Whether this susceptibility is restricted to nasopharyngeal carcinoma is unknown as information on the risk of other cancers in relatives is limited. We did a population-based study of the cancer incidence in nasopharyngeal carcinoma families in Greenland, a nasopharyngeal carcinoma-endemic area. Using population-based registers, a cohort of all persons born in Greenland was followed from 1973 to 2002. In this cohort, 134 individuals developed nasopharyngeal carcinoma and their relatives were identified through registers and interviews. Subsequently, the occurrence of cancer was determined by linkage to the population-based cancer register and the risk of cancer in nasopharyngeal carcinoma relatives and nonrelatives compared by relative risks. Among 766 first-degree relatives, the relative risk of nasopharyngeal carcinoma following the family index case was 8.0 [95% confidence interval (95% CI), 4.1-14.0]. Sex and age of the relative or the index case had no modifying effect on the familial risk of nasopharyngeal carcinoma. The relative risks of carcinoma of the salivary glands, 8.4 (95% CI, 2.7-19.5), and uterine cervix, 2.2 (95% CI, 1.1-3.9), were also significantly increased. In families with multiple cases of nasopharyngeal carcinoma, the risk of other cancers than nasopharyngeal carcinoma was further increased. These results indicate that the increased risk of cancer in nasopharyngeal carcinoma families is not restricted to nasopharyngeal carcinoma, but extends to the virally associated cancers of the salivary glands and cervical uteri.     

hsa_circ_0006220及hsa_circ_0001666在鼻咽癌患者血清中的表达及临床意义

目的:检测hsa_circ_0006220及hsa_circ_0001666在鼻咽癌患者血清中的表达水平,探究其对鼻咽癌的诊断效能。方法:应用环状RNA芯片技术在4例鼻咽癌及4例健康对照血清中筛选出特异性高表达的hsa_circ_0006220及hsa_circ_0001666,并使用RT-qPCR检测40例鼻咽癌、23例鼻咽炎患者及37例健康对照血清中的表达量,通过ROC曲线分析两者在鼻咽癌中的诊断价值,利用秩和检验比较不同分组中的相对表达量。结果:通过环状RNA芯片检测筛选出hsa_circ_0006220及hsa_circ_0001666在鼻咽癌患者血清中的表达水平高于健康对照。ROC曲线显示两者均有良好的诊断效能,当两者联合检测时,对于鼻咽癌的识别能力更佳。血清hsa_circ_0006220的相对表达量在鼻咽癌的不同淋巴结转移程度中具有差异。结论:环状RNA是鼻咽癌诊断的重要生物标志物。hsa_circ_0006220及hsa_circ_0001666在鼻咽癌患者血清中高表达,提示其在鼻咽癌的发生发展中具有重要作用,可成为鼻咽癌无创液体活检的新型候选标志物。     

GSTM1 and GSTT1 gene deletions and the risk for nasopharyngeal carcinoma in Han Chinese.

Southern China is a major nasopharyngeal carcinoma-endemic region. Environmental factors and genetic susceptibility contribute to nasopharyngeal carcinoma development in this area. Polymorphic deletions of GSTM1 and GSTT1 genes involved in the detoxification of potentially carcinogenic agents may be a risk factor for nasopharyngeal carcinoma. To investigate the roles of genetic variations of GSTM1 and GSTT1 in nasopharyngeal carcinoma susceptibility in the Chinese population, we conducted a case-control study of 350 nasopharyngeal carcinoma cases and 622 controls. GSTM1 and GSTT1 deletion variants were genotyped by multiplex PCR assays. Logistic regression analysis was used to estimate odds ratios and 95% confidence intervals (95% CI). No significant association was observed for either GSTM1- or GSTT1-null genotype independently in the contribution to nasopharyngeal carcinoma risk. To explore possible joint effects of the GSTM1- and GSTT1-null polymorphisms with each other and with other risk factors for nasopharyngeal carcinoma, we examined the association between each combined genotype and the risk for nasopharyngeal carcinoma stratified by gender and EBV replication status. We found that individuals who carried GSTM1/GSTT1-double null genotype had a higher risk for nasopharyngeal carcinoma in the male population (odds ratio, 1.76; 95% confidence interval, 1.04-2.97; P = 0.03); however, this was not significant after correction for multiple comparisons. No statistical difference was found between cases and controls in females and the subpopulation positive for immunoglobulin A antibodies to EBV capsid antigen for combined genotypes. Our results suggest that the GSTM1/GSTT1-double null genotype may be a risk factor for nasopharyngeal carcinoma among males in southern China, but this result warrants confirmation in other studies.     

Epstein-Barr virus in nasopharyngeal carcinoma in Indian patients

Formalin fixed paraffin embedded tissue blocks from 40 cases of nasopharyngeal carcinoma were investigated for the presence of Epstein-Barr virus (EBV). Heminested polymerase chain reaction was employed to amplify U 2 region of EBV DNA coding for EBNA 2 gene. This is the first study of its kind carried out in India. EBV was detected in 28 out of 40 (70%) nasopharyngeal carcinomas. Type A EBV was identified in 20 cases (71.4%), type B in 7 cases (25%) and coinfection in one case (3.5%). Either type A, or type B EBV, was identified in 22 out of 23 cases (95.7%) of undifferentiated nasopharyngeal carcinoma and 6 out of 15 cases (40%) of non keratinized squamous carcinoma. The higher incidence of EBV in non keratinized squamous carcinoma of nasopharynx assumes importance in view of the contrary reports in other studies. 26 cases were from Western India, of which 15 (57.6%) showed presence of type A EBV and 2 (7.6%) type B EBV. From Eastern Indian particularly Assam, 4 our of 5 cases showed positivity for type B EBV and 1 a coinfection. Whereas, from Bihar 3 out of 4 cases showed presence of type A EBV. From Middle East (Arabs) type A EBV was detected in 3 out of 5 cases of nasopharyngeal carcinomas. Geographically, type A EBV was far more prevalent in Western India, while in Eastern India particularly Assam, all five vases were positive for type B EBV. Thus, a significant variation in the type of EBV infection was observed in nasopharyngeal carcinoma in different ethnic populations in India.     

p53和nm23-H1在鼻咽癌组织中的表达及其意义

目的 探讨p53和nm23-H1蛋白在鼻咽癌中的表达及其与临床的相关性.方法 应用免疫组织化学方法对鼻咽癌40例、慢性鼻咽炎22例组织中p53和nm23-H1蛋白的表达进行检测,同时与临床相关资料进行对比研究.结果 慢性鼻咽炎组p53及nm23-H1蛋白的阳性率分别为1.0％、27.2％,而鼻咽癌组为92.5％、55.0％.在nm23-H1蛋白表达阳性的22例鼻咽癌组织中p53阳性表达9例（40.9％）,在nm23-H1表达阴性的18例中p53蛋白阳性表达17例（94.4％）.鼻咽癌组织中p53和nm23-H1蛋白的表达明显高于慢性鼻咽炎组织.p53蛋白表达与鼻咽癌淋巴结转移、临床分期和病理学分级呈正相关,与肿瘤T分级无关;nm23-H1蛋白表达与鼻咽癌淋巴结转移及临床分期呈负相关,与肿瘤T分级无关.结论 抑癌基因p53和nm23-H1在鼻咽癌的发生、发展及转移过程中起着协同、调控作用,可成为临床诊断和评价预后的重要生物学标志.     

MTA1在鼻咽癌中的表达及意义

目的探讨MTA1在鼻咽癌中的表达及临床意义.方法应用逆转录-PCR（RT-PCR）技术,检测43例鼻咽癌组织和14例正常鼻咽部组织中MTA1 mRNA的表达. 结果 MTA1 mRNA 在鼻咽癌组织的平均表达水平明显高于鼻咽部正常组织（P〈0.05）.鼻咽癌组织中MTA1 mRNA高表达率与临床分期、T分期和N分期呈正相关关系.结论 MTA1基因过度表达与鼻咽癌浸润和转移密切相关.MTA1 mRNA的过度表达可能是评价鼻咽癌的恶性程度、转移的重要指标.     

2007～2008年广西苍梧县石桥镇鼻咽癌普查结果初步分析*

目的:通过鼻咽癌普查了解广西苍梧县高发区鼻咽癌流行状况,探讨可持续发展的鼻咽癌早诊早治普查模式。方法:于2007年6 月～2008年12月在广西苍梧县石桥镇鼻咽癌现场进行鼻咽癌普查。在鼻咽癌现场建立人口档案;进行流行病学调查;参加普查者均进行头颈部检查及间接鼻咽镜检查,鼻咽癌EB病毒壳抗原IgA 抗体（IgA/VCA ）和早期抗原IgA 抗体（IgA/EA）血清学检测;检查结果可疑和血清学结果阳性者均进行鼻内镜检查;鼻咽部可疑病变者行活组织病理检查;鼻咽癌普查结果均输入电脑,应用EpiData3.1 建立数据库。结果:鼻咽癌现场筛查人群8 458 人,其中EB病毒IgA/VCA 阳性522 例,EB病毒IgA/EA阳性28例,进行鼻内镜检查410 例,鼻咽部活组织检查45例,检出鼻咽癌12例,其中早期鼻咽癌6 例,接受治疗11例。鼻咽癌人群检出率141.87/10 5,早诊率50% ,治疗率91.6% 。结论:广西苍梧县鼻咽癌早诊早治普查方案是鼻咽癌防治的重要策略之一,而鼻咽癌早诊早治普查工作应持续发展。      

荧光定量聚合酶链反应检测EB病毒感染

 目的　建立检测EBV感染的新方法并观察EBV与鼻咽癌的关系。方法　鼻咽部活检组织和石蜡包埋标本 6 6例 ,采用荧光定量聚合酶链反应 (FQ PCR)和原位杂交 (ISH)两种方法检测EBV ,其检测结果与病理诊断对照。结果　FQ PCR检测EBV DNA阴性 5 2例 ,其中 5 1例为炎性病变 ,另 1例为腺癌 ;EBV DNA阳性 14例 ,其中 13例为鳞状细胞癌 ,另 1例虽为炎症 ,但部分上皮细胞呈不典型增生。ISH检测EBV阴性 4 9例 ,其中 4 7例为炎性病变 ,2例为癌。EBV阳性 17例 ,其中 12例为癌 ,5例为炎性病变。FQ PCR和ISH检测EBV结果 ,经卡方检测差异无显著性 (P >0 .0 5 )。结论　EBV感染与鼻咽癌有高度相关性。FQ PCR检测EBV具有方法简单、快速、定量准确等优点     

Effect of local radiotherapy on the antibody levels against EBV-induced early and capsid antigens (EA and VCA) in patients with certain malignant tumours

Antibodies to tumour-related and EBV-associated intracellular antigens were studied in 14 cases of Burkitt's lymphoma, 50 of nasopharyngeal carcinoma, 10 of maxillary carcinoma and 95 cases of other tumours, all of whom received radiotherapy in Nairobi. For up to 1 month after radiotherapy the cases of Burkitt's lymphoma recorded an increase in antibodies to early antigens (EA) amounting to, on average, about one titre step (p<0.001). During the same interval there was a small but significant increase in antibodies to viral capsid antigen (VCA) (mean 0.6 titre step; p<0.001). The patients with nasopharyngeal and maxillary carcinoma, too, showed a small but statistically significant increase in antibodies to VCA 2-6 months after radiotherapy (p<0.01 and 0.001, respectively), but no increase in antibodies to EA. On the contrary, in nasopharyngeal carcinoma patients there was a significant decrease in antibodies to EA 2-3 months after radiotherapy. In the group of other tumours there was no evidence of a change in antibodies to the intracellular antigens studied during any of the relevant intervals.