鼻咽癌颈淋巴结转移灶的B超扫描与临床触诊的对比研究

目的分析比较B超扫描与临床触诊在检查鼻咽癌患者颈淋结转移灶放前后有无数量，大小等方面不同的结果，探讨B超扫描在鼻咽癌颈淋巴结检查中的价值。方法对125例初发和复发的鼻咽癌患者颈淋巴结在放疗前、后进行临床触诊及B超检查，记录颈淋结有无、数量、大小等情况，并进行对比较，结果125例患者临床触诊共检出淋巴结302，B超检出363个触诊漏检率达16．8％，触诊双侧颈N0和单侧颈N0的假阴性率分别为31．4％和30．8％，颈淋巴结融合成团的8例患者，临床触诊其最大的淋巴结均≥4cm，而超检查结果均＜4cm。29例得发患者，，B超发现其中5例除单侧上颈有淋巴结外，同侧下颈也有淋巴结，共7个，触诊未及。13例超重或肥胖患者颈淋巴结大小触诊与B超检查及显著性差异（P＜0．05）放疗结束时对残留淋巴结的检查比较，两者有显著性差异（P＜0．05）。结论B超检查较临床触诊断鼻咽癌颈淋巴结准确性更高，对分期，指导鼻咽癌患者的治疗和判断预后均有积极意义。

Comparative Study of Ultrasonography and Manual Palpation of Cervical Lymph Nodes Metastasised from Nasopharyngeal Carcinoma

Objective To analysis the differences between ultrasonography and manual palpation such as whether there are cervical lymph nodes metastasis from nasopharyngeal carcinoma,the number,the size et al before and after radiotherapy,and to explore the value of ultrasonography in examining lymph nodes of the neck of nasopharyngeal carcinoma.Methods The cervical lymph nodes in 125 patients of incipient and recurrent nasopharyngeal carcinoma were given detailed examination with ultrasonography and manual palpation respectively before and after radiotherapy.Results Among 125 patients,302 lymph nodes were found with manual palpation,while 363 with ultrasonography.The missed detection rate of manual palpation was 16.8%,the false negative rate of double sides neck N 0and single side neck N 0 with manual palpation was 31.4% and 30.8% respectively.All the largest lymph nodes of 8 patients were all more than 4 cm by manual palpation but less than 4 cm by ultrasonography.5 of 29 recurrent patients were found that there were 7 lymph nodes of the lower part of neck besides upper part of neck with ultrasonography but there were none with manual palpation.There were significant difference in size of lymph nodes of 13 patients who were fat or overweight when measured by ultrasonography and manual palpation( P <0.05),and the remaines at the end of therapy which were measured with the two means were significantly different( P <0.05).Conclusion Ultrasonography was more accurate than manual palpation in measuring the lymph nodes of the neck of nasopharyngeal carcinoma,it should play an important part in clinical staging and in guiding treatment and in predicting curative effect.