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目的:从鼻咽癌2008分期临床应用的角度探讨其合理性,指出不足,完善分期。方法:收集我科收治的经病理确诊、无远处转移的初诊鼻咽癌患者100例,按各个分期标准中提及的所有解剖结构进行阅片,按2008分期、2002年UICC及’92分期的标准分别进行分期。结果:斜坡受侵比例最高为85%(85/100),翼内肌为37%(37/100),鼻腔为16%(16/100),口咽为3%(3/100)。淋巴结最大径>3 cm11例,仅依据淋巴结>3 cm而诊断为N2的只有1例。3种分期中T3及N0、N2数量有一定差别,但临床总分期基本一致。结论:鼻腔、口咽等解剖结构的定义过于局限,蝶骨大翼的定义及跨区淋巴结的归属需明确,颅神经受侵的MR诊断部位和标准需要完善,翼内肌的合理性有待研究,可制定出锁骨上区的影像学边界,淋巴结大小作为N参数可保留。
Objective: To discuss its rationality from the point of clinical application of nasopharyngeal carcinoma 2008 staging, point out deficiencies and improve the staging. Methods: 100 cases of nasopharyngeal carcinoma diagnosed by pathology and without distant metastasis were collected and read in all the anatomical structures mentioned in each staging standard. According to 2008 staging, UICC and ’92 staging in 2002 The standards were staged. Results: The maximum slope invasion rate was 85% (85/100), the internal wing muscle was 37% (37/100), the nasal cavity was 16% (16/100) and the oropharynx was 3% (3/100). Lymph node maximum diameter> 3 cm 11 cases, only based on lymph nodes> 3 cm and diagnosed as N2 only 1 case. There were some differences in the numbers of T3, N0 and N2 in the three stages, but the total clinical stage was basically the same. CONCLUSION: The definition of anatomical structure such as nasal cavity and oropharynx is too limited. The definition of sphenoid wing and the location of trans-regional lymph nodes need to be clarified. The MR diagnostic sites and standards for cranial nerve invasion need to be improved. The rationality of the medial wing muscle needs to be studied , Can develop a supraclavicular region of the image boundary, lymph node size as N parameters can be retained.