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诊断和处理癌瘤的最重要方面之一是正确估计损害的范围和蔓延程度。外科医生需要知道手术必须做到什么程度;放射治疗医生需要知道损害的范围,以便能使损害完全在照射野内。正确评价鼻腔和鼻窦癌瘤常有困难,疗效不够满意就足以证明诊断误差的幅度。本文的目的是:指出在评价这类癌瘤蔓延程度时,发生错误的范围,错误发生的常见部位,从而提出疗效差的缘由。作者们复查了由1957～1972年间624例鼻腔及鼻窦癌的病案记录,其中经手术者(根治术、次根治术、探查术)共392例。除去只有在麻醉下的检查,因资料不足和进行放射治疗者,只有282例有充分的术前(体检、X线)、术后资料,可以做癌瘤范围的实际比较。每个病案记录是在编码后以电子计算机进行分析的。将鼻腔和鼻窦分成13个部位,以A到N(I除外)来表示,即A代表筛窦,B为上鼻腔,c为上颌窦腔,D为
One of the most important aspects of cancer diagnosis and treatment is to correctly estimate the extent and spread of damage. The surgeon needs to know what the degree of surgery must be; the radiotherapist needs to know the extent of the damage so that the damage can be completely within the field. It is often difficult to correctly evaluate nasal and sinus cancers. The lack of efficacy is sufficient to justify the magnitude of the diagnostic error. The purpose of this paper is to point out the range of errors that occur when evaluating the degree of spread of this type of cancer, the common parts of the error, and the reasons for the poor efficacy. The authors reviewed the records of 624 cases of nasal and paranasal sinuses cancer between 1957 and 1972, of which 392 were operated (radical surgery, minor radical surgery, exploratory surgery). Excluding only under anesthesia examination, due to insufficient data and radiation therapy, only 282 patients had adequate preoperative (physical examination, X-ray), postoperative data, and can actually compare the extent of cancer. Each case record was analyzed by computer after being coded. The nasal cavity and paranasal sinuses were divided into 13 sites, represented by A to N (excluding I), namely, A represents the ethmoid sinus, B is the upper nasal cavity, c is the maxillary sinus cavity, and D is