国际肿瘤学杂志

国际肿瘤学杂志 ›› 2018, Vol. 45 ›› Issue (11): 652-656.doi: 10.3760/cma.j.issn.1673-422X.2018.11.003

• 论著 • 上一篇    下一篇

鼻咽癌2017版分期与2008分期局部侵犯的对比研究

潘兴喜，陈永发，李飞龙，刘敏东，唐武兵，杨文   

  1. 528200 佛山，南方医科大学附属南海医院肿瘤一区
  • 出版日期:2018-11-08 发布日期:2018-12-21
  • 通讯作者: 杨文，Email: fsnhyangwen@126.com E-mail:fsnhyangwen@126.com
  • 基金资助:
    广东省佛山市卫生和计划生育局医学科研项目（20180246）

Comparison analysis of local invasion between the Chinese 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma

Pan Xingxi, Chen Yongfa, Li Feilong, Liu Mindong, Tang Wu-bing, Yang Wen   

  1. Department of Oncology I, Nanhai Hospital Affiliated to Southern Medical University, Foshan 528200, China
  • Online:2018-11-08 Published:2018-12-21
  • Contact: Yang Wen, Email: fsnhyangwen@126.com E-mail:fsnhyangwen@126.com
  • Supported by:
    Foshan Medical Science and Technology Research Project of Guangdong Province of China (20180246)

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摘要： 目的 通过比较鼻咽癌2017版分期与2008分期T分期的差异，探讨T分期优化的可能，为进一步修订提供依据。方法 收集2009年9月至2017年5月在我院经病理确诊的183例初诊鼻咽癌患者的MRI资料，分别标记两种分期系统中提及的所有解剖部位，并根据两种分期标准进行分期，比较两种T分期的差异。结果 口咽、鼻咽、椎前肌、颈椎、下咽和眼眶侵犯均100%合并同期别或更高期别的T分期因素受侵。颈椎、眼眶和下咽的侵犯率较低（均<5.00%）。翼状结构受侵的发生率为15.30%，大部分合并颅底骨质破坏，仅1例为单独受侵。鼻旁窦受侵100%合并颅底骨质破坏。与2008分期相比，2017版分期T1+T2构成比由36.61%升至61.75%，T3+T4构成比由63.39%下降至38.25%，两种分期系统中T分期的构成比差异有统计学意义（χ2=26.94，P<0.001）。两种分期系统中T分期具有中等一致性（Kappa=0.514，P<0.001）。结论 2017版T分期仍有较大的简化及优化空间，删除口咽、鼻腔、椎前肌、鼻旁窦、颈椎、眼眶和下咽这些T分期因素，不会对T分期的构成产生影响。建议将翼状结构与颅底骨质合并为一解剖结构。

关键词: 鼻咽肿瘤, 肿瘤分期

Abstract: Objective To compare the difference of T-stage between Chinese 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma, and to investigate the optimization of T-stage and provide suggestions for further revision. Methods The MRI data of 183 patients with histology-proven newly diagnosed nasopharyngeal carcinoma in our hospital were enrolled from September 2009 to May 2017. All the anatomic sites mentioned in the two staging systems were marked, and all patients were staged according to the 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma. Comparisons of T-stage were made between the two staging systems. Results Involvement of oropharynx, nasopharynx, prevertebral muscles, cervical vertebra, hypopharynx and orbit were 100% accompanied with other same or more advanced T-stage classifications. The invasion rates of the cervical vertebra, orbit and hypopharynx were very low (all <5.00%). The incidence of involvement of pterygoid structure was 15.30%, most of which incorporated with erosion of skull base, only 1 case was invaded alone. All cases of involvement of paranasal sinuses were incorporated with erosion of skull base. Compared with the 2008 staging system, the consti-tuent ratio of T1+T2 in the 2017 staging system increased from 36.61% to 61.75%, and that of T3+T4 decreased from 63.39% to 38.25%, the constituent ratio of T-stage between the 2017 staging system and the 2008 staging system was significantly diffe-rent (χ2=26.94, P<0.001). There was moderate consistency of T-stage between these two staging systems (Kappa=0.514, P<0.001). Conclusion The T-stage of 2017 staging system still has a larger simplification and optimization space. Therefore, according to the principle of concise, the T-stage parameters including oropharynx, nasopharynx, prevertebral muscles, paranasal sinuses, cervical vertebra, orbit and hypopharynx are recommend to delete, and it does not have an impact on the composition of T-stage. We suggest that the pterygoid structure shall combine with the skull base to be one anatomical structure.

Key words: Nasopharyngeal neoplasms, Neoplasm staging