鼻咽癌颅内转移相关临床病理因素的研究

目的　研究与鼻咽癌颅内转移有关的临床、病理因素 ,探讨有助于预测鼻咽癌颅内转移的危险因素。方法　对湖南省肿瘤医院 1995年 1月— 2 0 0 0年 12月的 2 0 0例鼻咽癌患者的临床资料进行回顾性分析 ,根据首发转移部位分组 ,研究 2 0例颅内转移的临床资料 ,并与淋巴结、骨、内脏转移患者的情况作比较。结果　颅内转移与患者年龄轻、临床体检颈淋巴结肿大、淋巴结转移数目、疾病分期及组织学类型相关。局部复发与否、颈淋巴结转移数与颅内转移相关。局部复发和 /或淋巴结转移组与局部复发伴远处转移组中浸润癌所占比例明显高于颅内转移组 ,颅内转移和内脏转移及淋巴结转移的时间分布无差别 ,局部复发组复发时间较颅内转移组早。结论　年轻的局部复发或临床体检颈淋巴结肿大者及浸润性癌的鼻咽癌患者应定期做MRI或CT ,以便早诊断早治疗颅内转移癌。

Study of clinical pathologic factors related to encephalic metastasis in nasopharynx carcinoma

Objective It is to study the clinical and pathologic factors related to encephalic metastasis in nasopharynx carcinoma and to discuss the risk factors helping to predict the encephalic metastasis.Methods The clinical data of 200 patients with nasopharynx carcinoma from January 1995 to December 2000 in Hunan provincial tumor hospital were analyzed retrospectively. These patients were divided into groups according to first carcinoma part. Then the clinical data of 20 cases with encephalic metastasis were analyzed and compared with that of lymph node, bone and visceral metastasis cases.Results Encephalic metastasis was related to young age, clinical checkup neck lymph node swell, the number of lymph node metastasis, disease stage and histological type. Local recurrence or not and the number of neck lymph node metastasis were related to encephalic metastasis. Invasive carcinoma rates in local recurrence and/or lymph node metastasis group and local recurrence combined with distance metastasis group were obviously higher than that in encephalic metastasis group. The occurrence of encephalic metastasis, visceral metastasis and lymph node metastasis had similar time distribution. However, the time of local recurrence was earlier than encephalic metastasis.Conclusion MRI or CT should be done termly in nasopharynx patients with young age, local recurrence, clinical checkup neck lymph node swell and invasive carcinoma in order to diagnose and treat encephalic metastasis earlier.