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目的：目前鼻咽癌各分期的T标准均包含CT内容，本研究旨在探讨CT扫描在鼻咽癌N分期的作用。方法：194例病理确诊的初诊鼻咽癌病人，均行颅底、鼻咽及颈部CT增强扫描，分析临床检查及CT影像资料。结果：72例N0病人有15例(20.8％)升级为N1；59例N1病人中有2例（3.4％）升级为N2，86例临床单侧淋巴结转移病人有13例（15.1％）CT影像发现双侧淋巴结转移。CT扫描颈部淋巴结的大小为：最大横径为(16.7±10.1)mm；最大纵径为(18.9±14.1)mm。临床触诊最大横径为(27.4±17.4)mm；最大纵径为(28.6±18.7)mm。临床触诊淋巴结大小与CT影像上淋巴结大小差别显著(P<0.001)。咽后淋巴结转移率为32.9％(64/194)。N0病人咽后淋巴结转移率为20.3％。结论：结合颈部增强CT扫描，部分病人N分期升级，同时明确淋巴结的数目和大小，使预后及放射治疗计划发生改变，建议鼻咽癌的N分期标准应包含CT内容。
Objective: At present, the T criteria of nasopharyngeal carcinoma staging include CT contents. This study aims to investigate the role of CT scanning in N staging of nasopharyngeal carcinoma. Methods: A total of 194 pathologically diagnosed nasopharyngeal carcinoma patients underwent skull base, nasopharynx and neck CT enhanced scanning, clinical examination and CT image data analysis. Results: Fifty-two (20.8%) of 72 patients with N0 were upgraded to N1. Two of 59 patients with N1 (3.4%) were upgraded to N2. Thirteen (15.1%) CT images of sixteen patients with clinical unilateral lymph node metastasis Bilateral lymph node metastasis was found. The size of CT scan of cervical lymph nodes was (16.7 ± 10.1) mm in maximum transverse diameter and (18.9 ± 14.1) mm in longitudinal diameter. The maximum diameter of clinical palpation was (27.4 ± 17.4) mm and the maximum longitudinal diameter was (28.6 ± 18.7) mm. The size of clinical palpation lymph nodes was significantly different from that of CT images (P <0.001). Pharyngeal lymph node metastasis rate was 32.9% (64/194). N0 patients with retropharyngeal lymph node metastasis rate was 20.3%. Conclusion: In combination with neck enhanced CT scans, some patients with N stage upgrade, at the same time clear the number and size of lymph nodes, the prognosis and radiotherapy plans to change, suggest that the N staging of nasopharyngeal carcinoma should include CT content.