多层螺旋CT断层扫描动态增强扫描及电子鼻咽镜检查在鼻咽癌早期诊断中的联合应用

Clinical application of electronic nasopharyngoscope combined with computed tomography scan in early diagnosis of nasopharyngeal carcinoma

目的探讨多层螺旋计算机(CT)断层扫描动态增强扫描联合电子鼻咽镜检查在鼻咽癌早期诊断中的应用效果。方法选取2013年3月至2015年8月间广东医学院附属中山医院收治的39例鼻咽癌患者,根据患者主要临床症状分为Ⅰ组(颅神经损伤组)、Ⅱ组(颈部淋巴结肿大组)及Ⅲ组(耳鼻症状组),3组患者均给予多层螺旋CT动态增强扫描及电子鼻咽镜检查,并分析联合检查结果。结果 3组患者多层螺旋CT动态增强扫描及电子鼻咽镜检查阳性率间差异无统计学意义(P>0.05)。多层螺旋CT动态增强扫描显示Ⅱ组患者咽旁间隙受侵率明显高于其他两组,差异有统计学意义(P<0.05)。Ⅲ组患者颅底受侵袭率明显高于其他两组,差异有统计学意义(P<0.05)。复发患者多层螺旋CT动态增强扫描假阳性率高于电子鼻咽镜检查结果,差异有统计学意义(P<0.05)。结论多层螺旋CT动态增强扫描联合电子鼻咽镜能准确诊断鼻咽癌及复发病例,在鼻咽癌早期诊断中具有重要的临床应用价值。

Objective To explore the clinical application efficacy of electronic nasopharyngoscope combined with computed tomography （CT） scan in early diagnosis of nasopharyngeal carcinoma. Methods From March 2013 to August 2015 in Zhongshan Hospital of Guangdong Medical College, 39 patients with nasopharyngea/carcinoma were enrolled in the study and divided into three different groups according to major clinic symptoms, three groups were Ⅰ group （ cranial nerve involvement group） , Ⅱ group （ symptom of neck lymph-node group） and Ⅲ group （ symptom of ear or nose group）. 39 patients were examined by electronic nasopharyngoseope combined with CT scan. Results The positive rating of electronic nasopharyngoscope and CT scan in the three groups showed no significant difference （ P 〉 0.05 ）. The ratios of involvement of lateral pharyngeal space examined by CT scan in group Ⅱ were 76.4%, and that of group Ⅱ was in the top of three groups, and the difference between the three groups was significant （ P 〈 0. 05 ）. The ratios of destruction of basis skull bone of group Ⅲ was in the top of three groups, and the difference between the three groups was significant （ P 〈 0. 05 ）. The false positive rate of recurrent patients by CT scan was higher than electronic nasopharyngoscope, and the difference between the two methods was significant （ P 〈 0. 05）. Conclusion Electronic nasopharyngoseope combined with CT scan has good accuracy in early diagnosis of nasopharyngeal carcinoma. It is a good method to diagnose nasopharyngeal carcinoma and recurrence.