鼻咽癌的CT表现类型与颈淋巴结转移和预后的初步研究

The Preliminary Study of the Relationship Between NPC Type on CT and CLN Metastasis as well as Prognosis

目的：加深对鼻咽癌（ＮＰＣ）ＣＴ表现３种类型的认识。材料与方法：１１８例ＮＰＣ，颈淋巴结转移８９例，有完整的３年追踪资料者６４例，其中远处转移和／或局部复发者２７例。根据ＣＴ表现将１１８例ＮＰＣ分为Ⅰ型（ｎ＝２４），Ⅱ型（ｎ＝６０），Ⅲ型（ｎ＝３４），并将ＣＴ表现３种类型与颈淋巴结转移、远处转移和／或局部复发进行相关性研究。结果：ＣＴ所见Ⅱ型较Ⅰ型更易发生颈淋巴结转移，与Ⅰ型和Ⅱ型比较，Ⅲ型转移之淋巴结多小于３ｃｍ；Ⅰ型放疗后３年转移率、复发率较Ⅱ、Ⅲ型为低，随癌肿向深层蔓延，其局部复发和远处转移率逐渐升高，预后愈来愈差。结论：ＣＴ表现分３型能初步反映ＮＰＣ恶性程度。

Objective: To make a further understanding of 3 CT types of nasopharyngeal carcinoma (NPC).Materials and Methods:Of 118 cases with NPC in this paper, 89 had cervical lymph node (CLN) metastasis, 64 were followed up for 3 years, and 27 had distant metastasis and/or local recurrence. According to CT findings, 118 cases were categorized into type Ⅰ (n=24) , type Ⅱ (n=60) and type Ⅲ (n=34). The relationship between CT type and CLN metastasis, distant metastasis, local recurrence was analyzed.Results:The incidence of CLN metastasis was higher in type Ⅱ than in type Ⅰ. Most metastatic CLN was less than 3cm in type Ⅲ. The incidence of metastasis and recurrent within 3 years after radiotherapy in type Ⅰ was lower than that in type Ⅱ and Ⅲ. With the infiltrating of the tumor into the deep layers of the nasopharynx, the local recurrence and distant metastasis were increased, and the prognosis became worse.Conclusion: The classification of 3 types of NPC on CT images roughly represents the different malignant degree of NPC.