鼻咽癌放疗后鼻咽颅底坏死与肿瘤复发鉴别的研究

Study on differentiation of nasopharyngeal skull base necrosis and tumor recurrence after radiotherapy for nasopharyngeal carcinoma

摘要:

目的 本研究通过对鼻咽癌(NPC)放疗后鼻咽颅底坏死及肿瘤复发患者的基本信息、症状、内镜及影像学等进行对比，探讨两者差异性，为患者的诊断提供依据，利于临床评估和制定精准的治疗方案。方法 以2012年1月—2022年4月38例NPC放疗后鼻咽颅底破坏患者为研究对象，根据病理结果分为坏死组和复发组，对比两组性别构成、发病年龄、二次放疗、发病时间、鼻内镜检查表现、CT及MRI影像表现的差异。结果 两组在性别构成、发病时间、二次放疗、鼻腔恶臭、内镜下鼻咽坏死情况及新生物情况、CT骨质破坏表现、鼻咽软组织强化后表现、MRI中软组织及骨髓T2及强化表现上存在显著差异(P＜0.05)。结论 通过对NPC放疗后鼻咽颅底破坏患者的性别、发病时间、临床症状、鼻内镜表现、CT、MRI表现进行综合分析，能够对NPC放疗后鼻咽颅底坏死与肿瘤复发进行初步鉴别，有助于临床上制定精准的治疗方案。

关键词:鼻咽癌;CT;肿瘤复发;鼻内镜;MRI

Abstract:

Objective To explore the differences between nasopharyngeal skull base necrosis and tumor recurrence after radiotherapy of nasopharyngeal carcinoma (NPC) by comparing their basic information, symptoms, endoscopic and imaging results, so as to provide basis for the diagnosis of patients and facilitate the evaluation and formulation of accurate treatment plans. Methods A total of 38 NPC patients with nasopharyngeal skull base destruction after radiotherapy from January 2012 to April 2022 were selected as the study objects. According to pathological results, they were divided into necrosis group and recurrence group. Differences in gender composition, age of onset, secondary radiotherapy, onset time, nasal endoscopic, computed tomography (CT) and magnetic resonance imaging (MRI) findings were compared between the two groups. Results There were significant differences between the two groups in gender composition, onset time, secondary radiotherapy, nasal odor, endoscopic nasopharyngeal necrosis and neoplasm, CT manifestations of bone destruction and nasopharyngeal soft tissue enhancement, and MRI T2 and enhancement of soft tissue and bone marrow (P<0.05). Conclusion Through comprehensive analysis of the gender, onset time, clinical symptoms, nasal endoscopic findings, CT and MRI findings of the patients with nasopharyngeal skull base destruction after radiotherapy, the preliminary differentiation between nasopharyngeal skull base necrosis and tumor recurrence after radiotherapy for NPC can be made, which is conducive to the development of accurate clinical treatment plans.

Key words:Nasopharyngeal carcinoma;Computer tomography;Tumor recurrence;Nasal endoscope;Magnetic resonance imaging