鼻咽癌原发肿瘤体积与临床T分期关系探讨

The Study on Relationship between Primary Tumor Volume and Clinical T Staging of Nasopharyngeal Carcinoma

目的:探讨鼻咽癌原发肿瘤体积与临床T分期之间的关系,为鼻咽癌合理分期提供理论依据。方法:43例鼻咽癌患者放疗前行CT增强扫描检查,采用3D-Doctortm影像学软件,勾画各层面原发肿瘤轮廓,计算原发肿瘤体积大小。结果:依照92'分期标准,不同T分期肿瘤体积分别为:T115.99±4.20cm3、T229.95±6.61cm3、T340.62±8.11cm3、T456.56±8.23cm3,各期间具有统计学差异(F=37.60,P<0.01)。早期(T1+T2)和进展期(T3+T4)肿瘤体积具有显著性差异(t=6.38,P<0.01)。相邻T分期中肿瘤体积分布具有重叠情况。结论:92'分期标准能基本反映鼻咽癌肿瘤体积在不同T分期中的分布情况。建议将体积因素加入T分期,在单一分期中细分为不同亚型,区别预后,使分期更具有科学性和合理性。

Objective： To investigate the relationship between primary tumor volume and clinical T staging of nasopharyngeal carcinoma （NPC）, so as to provide theoretical evidences for reasonable clinical staging of NPC. Methods： Forty-three patients received CT enhanced scanning before radiotherapy. Then each layer contour of primary tumor was sketched by 3D-Doctor^tm software, volume of primary tumor was computed. Results： According to the 92 staging, the average volume for different T staging is as followed： TI =15.99±4.20cm^3, T2=29.95±6.61cm^3, T3=40.62±8.1 1cm^3 and T4=56.56±8.23cm^3, respectively, having significant difference in each stage analyzed by statistics （F=37.60, P〈0.01 ）. Comparing the NPC volumes of previous（T1＋T2） stages with that of advanced （T3＋T4）, with average values of 26.78±8.51cm^3 and 45.93±11.06cm^3, there is also a significant difference in statistics （t=6.38,P〈0.01）. There was an overlap in distribution of tumor volume in adjacent T staging. Conclusions： The 92 staging can reflect the distribution of different T staging in tumor volume of NPC on the whole. It is suggested that volume factor be listed in T staging and subdivided in current single stage, in order to differentiate prognosis making staging scientific and rational.