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目的 分析颈部淋巴结活检与穿刺对鼻咽癌远处转移的影响。方法 12 0例 N1 ～ N3鼻咽癌行放射治疗 ,其中 12例放疗前行颈部淋巴结活检 ,3 6例放疗前行颈部淋巴结穿刺。结果 未行颈部淋巴结活检、穿刺 ( A组 )与行颈部淋巴结穿刺 ( B组 )、活检 ( C组 )的 5年无远处转移率分别为 80 .2 %、60 .6%、4 5 .8% ,差异有显著性 ( P=0 .0 0 82 ) ;颈部淋巴结活检、穿刺与治疗间隔≤ 2周 ( D组 )、>2周 ( E组 )与未行此两项检查 ( A组 )比较 ,D组无远处转移率无明显下降 ( P=0 .94 77) ,E组有显著性下降 ( P=0 .0 0 16)。结论 鼻咽癌远处转移率不但与 N分期有关 ,还与是否行颈部淋巴结活检、穿刺有关 ,而且与此检查至放疗的间隔时间长短有关 ,间隔长 ,远处转移率高。
Objective To analyze the influence of cervical lymph node biopsy and puncture on distant metastasis of nasopharyngeal carcinoma. Methods A total of 120 cases of N1 ~ N3 nasopharyngeal carcinoma were treated by radiotherapy. Twelve cases underwent cervical lymph node biopsy before radiotherapy and 36 cases received cervical lymph node puncture before radiotherapy. Results None of the cervical lymph node biopsy, biopsy (group A) and cervical lymph node biopsy (group B), biopsy (group C) 5 years without distant metastasis rates were 80.2%, 60.6%, 4 (P = 0.082); cervical lymph node biopsy, puncture and treatment interval ≤ 2 weeks (D group),> 2 weeks (E group) and did not do these two tests (Group A), there was no significant decrease in distant metastasis rate in group D (P = 0.9477), while in group E, there was a significant decrease (P = 0.060). Conclusion The distant metastasis of nasopharyngeal carcinoma is not only related to the N stage, but also to the biopsy and puncture of the cervical lymph nodes. It is also related to the interval between the examination and the radiotherapy, with long interval and high distant metastasis rate.