鼻咽癌原发灶肿瘤体积与2008T分期关系的探讨

摘要

Objective To investigate the relationship between primary tumor volume( TV ) and clinical T staging of na-sopharyngeal carcinoma ( NPC ). Methods 189 patients with newly histologically diagnosed NPC were staged with magnetic resonance imaging examination of the neck and nasopharynx before radiotherapy. Primary tumor in each axis scan was delineated with polygon measurement tool in the medical picture archiving and communication system ( PACS ). The area of each scan auto-displayed in PACS and slice thickness were recorded and TV was calculated with summation of area technique. Results The mean TV for the whole series was ( 19.70 ± 16. 80 )cm3[ range(1. 04~97. 04 )]cm3,for different T stage was as followed:Tl( 6. 60 ± 3.24)cm3[range( 1.04 ~ 14. 36 )cm3 ],T2(9. 98±4.41 )cm3[ range,( 4. 99~21.55)cm3 ],T3( 17.96± 10. 19 )cm3[ range ( 2. 33 ~ 50. 13 )cm3 ],T4( 35. 19 ± 19. 76 )cm3[ range( 11. 78 ~ 97. 04 )cm3 ] respectively. Differences in TV among the various T stages was statistically significant ( P = 0. 000, Kruskal-Wallis test ). TV between adjacent T stages were compared by two-two test. Differences between T1/T2 T2 /T3 and T3 /T4 were all statistically significant ( P <0. 00 ). Conclusion The 2008 staging system of NPC can reflect the distribution of different T staging in tumor volume of NPC on the whole. Though there was an overlap between each adjacent T stage especially between T2/T3,T3 /T4,Not to reach statistical significance.%目的 探讨鼻咽癌原发灶肿瘤体积与临床T 分期的关系.方法 对189例患者治疗前行鼻咽全颈MRI平扫及增强,采用面积求和方法计算鼻咽原发灶肿瘤体积.结果 全组鼻咽原发灶肿瘤平均体积为(19.70 ±16.80)cm3[(1.04～97.04)cm3],各T分期鼻咽原发灶肿瘤体积如下:T1期(6.60±3.24)cm3 [(1.04～14.36)cm3],T2期(9.98±4.41)cm3[(4.99~21.55)cm3],T3期(17.96±10.19)cm3[(2.33～50.13)cm3],T4期(35.19±19.76)cm3[(11.78～97.04)cm3].鼻咽癌原发灶肿瘤体积T1～T4期各分期间比较均有非常显著性差异(P<0.00).结论 鼻咽癌2008分期的T分期标准基本上可以反映鼻咽原发灶肿瘤体积,虽然各T分期体积分布有部分重叠范围,但不影响统计学意义.