从鼻咽癌微小原发灶探讨其好发部位

Investigation of the site of origin to develop micro-focal nasopharyngeal carcinoma

目的从鼻咽癌微小原发灶探讨其好发部位。方法对1994年3月至2003年6月间经病理证实的32例鼻咽癌患者的原发部位进行统计分析。32例患者具有病变局限的微小病灶,CT显示为T0或T1。结果原发病变位于咽隐窝者3例,位于顶壁者20例,位于后壁者9例。CT图像显示,鼻咽部各壁(含咽隐窝)正常者24例(75.0%);一侧后壁黏膜轻微隆起而咽隐窝正常者5例(15.6%);咽侧壁和(或)咽隐窝受累3例(9.4%),即为临床检查原发病变位于咽隐窝者。结论鼻咽癌临床早期(T0或T1)微小原发灶多见于顶壁,其次是后壁,而后才是咽隐窝。晚期患者大多数累及咽隐窝,可能是顶壁或后壁肿物向咽隐窝扩展的结果。

Objective To investigate the prevalent area where the nasopharyngeal carcinoma （NPC） initially would develop most frequently in the nasopharynx. Methods From March, 1994 to June, 2003, the data of original micro-focus of 32 pathologically confirmed NPC were retrospectively reviewed, All cases were shown by CT to have stages T0 or T1 lesions. Results On clinical examination, only 3 cases （9.4%） were found to have original micro-tumor in the recess, the other 29 cases （90.6%） had developed from the other regions including 20 （69.0%） from the roof and 9 cases （31.0%） from the posterior wall, all with the mucosa in the recess smooth and symmetrical. However, CT images showed that membrane of all the nasopharyngeal wails, including the recess, were normal in 24 cases （75.0%）; except the micro-foci were observed on one side of the posterior wall in 5 cases（15.6%） but still with the recess normal, One lateral wall and/or the recess were involved with abnormal appearance in 3 cases （9.4%） who were clinically found to have NPC focus originated from the recess. Conclusion Our data suggest that the roof of nasopharygeal cavity may be the area likely to develop the original NPC micro-focus, followed in frequency by the posterior wall, with the recess the least likely. The recess involvement observed in advanced lesions may be the extension of the NPC focus from the original site on the roof or the posterior wall of nasopharynx.