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333例鼻咽癌咽后淋巴结转移特点的MRI分析

覃玉桃, 张日光, 阮林, 吴芳, 王仁生

覃玉桃, 张日光, 阮林, 吴芳, 王仁生. 333例鼻咽癌咽后淋巴结转移特点的MRI分析[J]. 肿瘤防治研究, 2013, 40(09): 848-852. DOI: 10.3971/j.issn.1000-8578.2013.09.007
引用本文: 覃玉桃, 张日光, 阮林, 吴芳, 王仁生. 333例鼻咽癌咽后淋巴结转移特点的MRI分析[J]. 肿瘤防治研究, 2013, 40(09): 848-852. DOI: 10.3971/j.issn.1000-8578.2013.09.007
QIN Yutao, ZHANG Riguang, RUAN Lin, WU Fang, WANG Rensheng. MRI Analysis of Metastasis of Retropharyngeal Lymph Nodes in 333 Patients with Nasopharyngeal Carcinoma[J]. Cancer Research on Prevention and Treatment, 2013, 40(09): 848-852. DOI: 10.3971/j.issn.1000-8578.2013.09.007
Citation: QIN Yutao, ZHANG Riguang, RUAN Lin, WU Fang, WANG Rensheng. MRI Analysis of Metastasis of Retropharyngeal Lymph Nodes in 333 Patients with Nasopharyngeal Carcinoma[J]. Cancer Research on Prevention and Treatment, 2013, 40(09): 848-852. DOI: 10.3971/j.issn.1000-8578.2013.09.007

333例鼻咽癌咽后淋巴结转移特点的MRI分析

基金项目: 广西医疗卫生重点科研基金资助项目(2010011)
详细信息
    作者简介:

    覃玉桃(1965-),女,硕士,副主任医师,主要从事鼻咽癌等头颈部肿瘤的临床放疗研究

  • 中图分类号: R739.63;R445.2

MRI Analysis of Metastasis of Retropharyngeal Lymph Nodes in 333 Patients with Nasopharyngeal Carcinoma

  • 摘要: 目的 了解鼻咽癌咽后淋巴结的发生率及特征,探讨其与受累部位、颈部淋巴结转移的关系。 方法 回顾性分析333例经病理证实、无远处转移的初诊鼻咽癌患者MRI资料。根据2008临床分期标准进行分期。采用率的比较分析咽后淋巴结转移与临床分期、肿瘤侵犯部位及颈部淋巴结转移的关系。 结果 (1)咽后淋巴结阳性率为66.3%,其中单侧41.4%,双侧24.9%;不同T、N分期(T1、T2、T3、T4;N1b、N2、N3)的咽后淋巴结转移率均不同,其中T1期均低于T2、T3以及T4期(P<0.05),N1b期均较N2、N3期低(P<0.05);(2)茎突前间隙、颈动脉鞘区、口咽、椎前肌、翼内肌等结构侵犯者的咽后淋巴结转移发生率均明显高于其未侵犯者(P<0.05);(3)全组病例颈淋巴结转移率为82.0%,其中咽后淋巴结阳性者高于阴性者(87.8% vs.70.5%,P<0.05);双侧咽后淋巴结转移者高于单侧转移者(94.0% vs. 84.1%,P<0.05);(4)咽后淋巴结最大直径≤20 mm与最大直径>20 mm患者的颈淋巴结各区转移率差异无统计学意义(P>0.05)。 结论 (1)鼻咽癌咽后淋巴结转移率高与茎突前间隙、颈动脉鞘区、椎前肌、翼内肌及口咽侵犯相关;(2)鼻咽癌咽后淋巴结转移影响颈淋巴结的转移;(3)咽后淋巴结的直径大小与颈淋巴结各区转移无相关性。

     

    Abstract: Objective To investigate the incidence and characteristic of retropharyngeal lymph nodes and explore its relationship with located invasion and metastasis of cervical lymph nodes in nasopharygeal carcinoma. Methods Retrospectively reviewed the data of MRI from 333 NPC patients with non-distant metastasis and newly diagnosed with NPC by pathology. And the 2008 staging system was used to determine the clinical stage of each NPC patients. And the rate comparison was used to explore the relationship between the RLN and the invaded lication and the metastasis of cervical lymph nodes. Results (1) The positive rate of retropharyngeal lymph node was 66.3%(unilateral was 41.4% and bilateral was 24.9%). The retropharyngeal lymph node metastasis rate of T stages was different from N stages. And the positive rate of T1 stage was significantly lower than that of T2, T3 and T4 stage(P<0.05). N1b had a significantly lower positive rate compared with N2, N3 stage. (2) The positive rate of retropharyngeal lymph node of patients with invasions of pre-styloid space, carotid sheath, oropharynx, prevertebral muscle and medial pterygoid were significantly higher than that of patients without invasions. (3) The positive rate of cervical lymph node was 82.0%(273/333), thereinto, patients with retropharyngeal lymph node metastasis had significantly higher positive rate than those without metastasis (87.8%vs. 70.5%,P<0.05). The unilateral metastasis was lower than the bilateral (84.1% vs. 94%)(P<0.05). (4) The positive rate of cervical lymph node was not significantly different between patients with the more than 20 mm diameter of retropharyngeal lymph node and those with less than 20 mm(P>0.05). Conclusion (1) The high positive rate of retropharyngeal lymph node is related to the invasion of pre-styloid space, carotid sheath, oropharynx, prevertebral muscle and medial pterygoid. (2) The metastasis of retropharyngeal lymph node influences the invasion of cervical lymph node.(3) The diameter of retropharyngeal lymph node has no correlation with the located of invation of cervical lymph node.

     

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出版历程
  • 收稿日期:  2012-09-10
  • 修回日期:  2013-01-29
  • 刊出日期:  2013-09-24

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