The diagnosis of nasopharyngeal carcinoma

The diagnosis of nasopharyngeal carcinoma, nasopharyngeal carcinoma 5-year survival rate after treatment was: I of 95%, II in 80%, while the field of 62%, N of 40%. Thus, the key is to improve the efficacy of early diagnosis and early treatment. However, due to the following causes nasopharyngeal cancer diagnosis is not easy: growth position concealed; no specific early symptoms; some patients, even to the late symptoms have no ear, nose; first admissions physician's negligence. Therefore, to achieve early diagnosis, we must do the following:
1. Vigilant, pay attention to the patient's chief complaint
Suction on a back tears of blood, persistent nasal obstruction, unilateral tinnitus, painless cervical lymph nodes, headache, unexplained symptoms such as cranial nerve damage in patients, should be the nasopharynx by indirect nasopharyngeal mirror or electronic microscope carefully Check the nasopharynx.
2. Cervical lymph node examination
Note Check the internal jugular chain, the transverse cervical nerve chain, and whether the lymph nodes arteriovenous chain.
3. Cranial nerve examination cranial nerve examination not only conventional manner by one carefully, but also suspected ocular, masticatory muscle and tongue muscle paralysis, sometimes have to repeatedly check to lead to positive results.
4. EB virus serology
At present, the routinely used NPC screening indicators IgA / VCA, IgA / EA, EBV-DNaseAb. The detection rate of nasopharyngeal antibody levels and change. Where one of the following conditions may be considered a high risk of NPC object:
(1) IgA / VCA antibody titers at one eighty on February 3;
(2) in the IgA / VCA, IgA / EA and EBV-DNaseAb any two of the three indicators is positive;
(3) The above three indicators, an indicator of any sustained high titer or a sustained elevated titer. People who meet the above criteria, should be done in careful observation of nasopharyngeal electronic microscope, if necessary, biopsy. Of particular note is the changes of serum EB virus can be confirmed in NPC 4_46 months ago that showed positive reaction, but to pay attention to false positives.
5. Diagnostic Imaging
(1) CT scanning: its clinical significance are: to assist diagnosis. determine extent of disease, accurate staging. correctly determine the treatment target, design radiation field. observed regression of tumors after radiotherapy and follow-up follow-up examination.
(2) magnetic resonance imaging (MRI): MRI with its excellent soft tissue resolution, and also to get cross-section, sagittal and coronal imaging is superior to CToMRI addition to the information clearly shows the level and structure of the nasopharynx outside the scope of the tumor can show early infiltration of the tumor on the bone. MRI of fibrosis after radiotherapy and the identification of tumor recurrence but also greater help.
(3) whole body bone imaging: diagnosis of bone metastases of nasopharyngeal carcinoma have a higher value than ordinary X-ray and CT-sensitive, usually earlier than the X-36 months. Whole body bone imaging scan, the lesions showed uptake in multiple foci; few showed radioactivity defect. Bone imaging in bone metastases with high sensitivity, but the lack of specificity. Therefore, the radioactive concentration of a single lesion in the next conclusion, should be combined with medical history, exclude surgical trauma, fractures, bone degenerative distortion and radiotherapy, chemotherapy and so on.
(4) positron emission tomography (positron emission tomography, PET): In vivo molecular biochemistry, also known as metabolic images. Glucose metabolism by 18-FDG imaging and CT of biological anatomical images acquired with the machine PET-CT fusion images can be provided to the clinical information of biological imaging to help determine the biological target of NPC to improve radiation therapy accuracy, thereby enhancing the efficacy and reduce normal tissue radiation injury.
The diagnosis of nasopharyngeal carcinoma 6. Histology
Nasopharyngeal nasopharyngeal carcinoma should be taken to send the organization of the primary tumor pathological examination before treatment to obtain a clear histological diagnosis; clinically only in the primary tumor can not be considered until a clear pathological diagnosis of cervical lymph node biopsy for.