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目的：研究无典型临床症状而ＥＢＶ检测阳性者，行鼻咽纤维镜下活检对确诊鼻咽癌的价值。方法：１９９０年４月至１９９３年４月间在中山医科大学肿瘤医院检查单纯ＥＢＶ ＶＣＡ／ＩｇＡ≥１：５、ＥＡ／ＩｇＡ≥１：５、ＥＤＡｂ≥３０％任何一项或以上阳性而无典型临床症状并到鼻咽科进行鼻咽纤维镜检查及作活检５４４人。对活检癌细胞阳性者治疗时的鼻咽ＣＴ按“９２分期”进行分期，了解分期情况。对活检阴性者随机了解男女各２５例的心理变化情况。结果：５４４例单纯ＥＢＶ阳性者活检确诊为鼻咽低分化鳞癌６４例，检出率１１．２１％，按“９２分期”Ｔ０４例，Ｔ１３１例，Ｔ２２９例。活检阴性者随机了解其心理情况的５０例有８２％的人活检前对自己ＥＢＶ阳性而怀疑患上鼻咽癌心里感到担忧、不安、有心理压力，经纤维镜观察未发现异常肿物活检结果为癌细胞阴性后才觉减压，对日后需随诊的意义有所认识。结论：对单纯ＥＢＶ阳性无典型临床症状者有必要及时进行鼻咽纤维镜检查，并作鼻咽癌好发部位活检，有助于早期鼻咽癌的确诊。对检查出鼻咽癌的患者其分期亦较早，有早诊作用，对活检后阴性的人群有心理减压作用。
Objective: To investigate the value of nasopharyngeal fiber biopsy in the diagnosis of nasopharyngeal carcinoma without typical clinical symptoms and positive EBV. METHODS: Between April 1990 and April 1993, at the Tumor Hospital of Sun Yat-sen University of Medical Sciences, there were no EBV VCA/IgA ≥ 1:5, EA/IgA ≥ 1:5, and EDAb ≥30% positive or negative. Clinical symptoms and nasopharyngeal examination were performed nasopharyngeal fiber biopsy and biopsy 544 people. The nasopharyngeal CT during the treatment of biopsy-positive patients was staged according to the “92-phase” staging to understand the staging. For those who were negative for biopsy, the psychological changes of 25 men and women were randomly understood. RESULTS: A total of 544 patients with EBV positive biopsy were diagnosed as having poorly differentiated squamous cell carcinoma of the nasopharyngeal in 64 cases. The detection rate was 11.21%. According to the “92 stage” T04 cases, T131 cases, and T229 cases. Among the 50 patients with negative biopsy who were randomized to understand their psychological conditions, 82% of them had concerns about their EBV positive and suspected nasopharyngeal cancer before biopsy. They were worried, disturbed and had psychological pressure. No abnormal biopsy results were found by fiberoptic observation. He felt decompression after being negative for cancer cells, and he knew the significance of follow-up consultation in the future. Conclusion: It is necessary to perform nasopharyngeal fiberoptic examination in time for patients with no typical clinical symptoms of EBV positive, and to perform biopsy at the site of nasopharyngeal carcinoma, which is helpful for the early diagnosis of nasopharyngeal carcinoma. The staging of patients with nasopharyngeal carcinoma was earlier and had a role of early diagnosis. Psychological decompression was applied to the negative population after biopsy.