摘要
目的探讨多层螺旋CT(MSCT)对鼻咽淋巴瘤(NPL)、鼻咽癌(NPC)的鉴别诊断价值。方法回顾性分析经活检和病理证实的55例NPL和62例NPC患者临床资料,所有患者均通过MSCT扫描,比较2组肿瘤形态、病变累及范围、颈部淋巴结转移差异及病灶强化程度。结果NPL患者病变较为表浅且呈弥漫性累及鼻咽腔者占60.00%,高于NPC患者的27.42%(χ^(2)=8.007,P<0.05);表现为局限性肿块29例(23.64%),低于NPC患者的46.77%(χ^(2)=6.781,P<0.05)。NPL患者中口咽部、鼻腔、副鼻窦及翼腭窝4个部位中至少2个部位同时受累者31例(56.36%),高于NPC患者7例(11.29%)(χ^(2)=27.000,P<0.05);NPL组出现颈部淋巴结肿大患者31例(56.36%),低于NPC组58例(93.55%)(χ^(2)=22.137,P<0.05);NPL组出现淋巴结明显坏死或包膜外侵犯者4例(6.90%),低于NPC组21例(33.87%)(χ^(2)=12.272,P<0.05)。NPL组平扫期、动脉期、实质期CT平扫、强化均值低于NPC组(P<0.05);平扫期、动脉期、实质期鉴别NPL、NPC ROC曲线下面积分别为0.757、0.785、0.774。结论NPC与NPL二者MSCT表现中肿瘤形态、病变累及范围、颈部淋巴结转移、病灶强化程度均存在差异。
Objective To explore the differential diagnosis value of multi-slice spiral CT(MSCT)in nasopharyngeal lymphoma(NPL)and nasopharyngeal carcinoma(NPC).Methods The clinical data of 55 NPL patients and 62 NPC patients who were confirmed by biopsy and pathology were retrospectively analyzed.All underwent MSCT scan.The tumor morphology,ranges of lesion involvement,differences in cervical lymph node metastasis and degree of lesion enhancement were compared between the 2 groups.Results The proportion of superficial lesions and diffuse involvement to nasopharyngeal cavity in NPL patients was higher than that in NPC patients(60.00%vs 27.42%)(χ^(2)=8.007,P<0.05).It showed that there were 29 cases(23.64%)with localized mass in NPL patients,lower than that in NPC patients(46.77%)(χ^(2)=6.781,P<0.05).In NPL patients,there were 31 cases(56.36%)with involvement in at least 2 sites(oropharynx,nasal cavity,paranasal sinuses,pterygopalatine fossa),higher than that in NPC patients[7 cases(11.29%)](χ^(2)=27.000,P<0.05).In NPL group,there were 31 cases(56.36%)with cervical lymphadenectasis,lower than that in NPC group[58 cases(93.55%)](χ^(2)=22.137,P<0.05).In NPL group,there were 4 cases(6.90%)with significant lymph node necrosis or extracapsular invasion,lower than that in NPC group[21 cases(33.87%)](χ^(2)=12.272,P<0.05).CT plain scans and enhanced mean values during plain scan phase,arterial phase and parenchymal phase in NPL group were low than those in NPC group(P<0.05).The areas under the ROC curves(AUC)values of plain scan phase,arterial phase and parenchymal phase for differential diagnosis of NPL and NPC were 0.757,0.785 and 0.774,respectively.Conclusion There are differences in tumor morphology,ranges of lesion involvement,cervical lymph node metastasis and degree of lesion enhancement in MSCT findings between NPC and NPL.
作者
郭胜男
王素雅
张广清
GUO Shengnan;WANG Suya;ZHANG Guangqing(Linzhou People's Hospital,Anyang,456550)
出处
《实用癌症杂志》
2021年第4期594-597,共4页
The Practical Journal of Cancer
关键词
鼻咽淋巴瘤
鼻咽癌
多层螺旋CT
鉴别诊断
Nasopharyngeal lymphoma
Nasopharyngeal carcinoma
Multi-slice spiral CT
Differential diagnosis
