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作者对本院1985年12月至1988年8月首次治疗前的196例鼻咽癌临床及CT扫描发现的资料进行了分析。单侧或双侧颈部淋巴结转移灶≥3cm者,咽旁间隙及颈动脉鞘受侵率分别为65.42％(70/017)及62.62％(67/017),但颈部淋巴结转移灶<3cm者,咽旁间隙及颈动脉鞘受侵率仅为15.63％(5/32)及12.5％(4/32),二者具有显著性差异(P<0.005);咽旁间隙及颈动脉鞘受侵者,颈部淋巴结转移率分别为84.27％(75/89)及84.52％(71/84)。4例后组颅神经受累者全部有咽旁间隙受累,其它颅神经受累者咽旁间隙受侵者仅为35.71％(10/28)。我们的资料表明,颈部淋巴结转移灶与颈动脉鞘关系密切,颈部淋巴结转移可能是原发灶直接侵犯颈动脉鞘后产生的。在缺少CT扫描的情况下,根据颈部淋巴结大小,我们提出鼻咽癌放疗设野的建议。
The authors analyzed the clinical and CT findings of 196 cases of nasopharyngeal carcinoma before the first treatment in our hospital from December 1985 to August 1988. Unilateral or bilateral cervical lymph node metastasis ≥3cm, parapharyngeal space and carotid sheath invasion rate were 65.42% (70/017) and 62.62% (67/017), respectively, but the cervical lymph node metastases <3cm The invasion rate of parapharyngeal space and carotid artery sheath was only 15.63% (5/32) and 12.5% (4/32) respectively. There was a significant difference between them (P<0.005); parapharyngeal space and carotid artery sheath. Invaders, the cervical lymph node metastasis rate was 84.27% (75/89) and 84.52% (71/84), respectively. All the 4 cases of posterior cranial nerve involvement were involved in the parapharyngeal space, and only 35.71% (10/28) of the other cranial nerves were affected by the parapharyngeal space. Our data shows that cervical lymph node metastases are closely related to the carotid sheath, and cervical lymph node metastases may be generated after the primary lesion directly invades the sheath of the carotid artery. In the absence of a CT scan, based on the size of the lymph nodes in the neck, we proposed a proposal for radiotherapy for nasopharyngeal carcinoma.