Nicholls J M, Sham J, Chan C W, Choy D
Department of Pathology, University of Hong Kong.
Hum Pathol. 1992 Jul;23(7):742-7. doi: 10.1016/0046-8177(92)90342-z.
Nasopharyngeal carcinoma is a common malignancy in Hong Kong and is treated by external radiotherapy. After 6.5 weeks of radiotherapy, the nasopharynx of 100 patients was examined and biopsy specimens were taken. All patients had repeated examination and biopsies done every 2 weeks until exophytic tumor was not seen and biopsy samples were negative on more than one examination of the nasopharynx. The interval between the cessation of therapy and biopsy ranged from 1 day to 11 weeks. Twenty-three patients had atypical findings and five of these had residual tumor requiring gold grain implantation brachytherapy. We identified a number of distinct pathologic changes in the post-biopsy material. Most of these changes disappeared 8 weeks after the cessation of therapy, but the presence of residual tumor after this time was an indication for subsequent therapy. If the date of the first biopsy was delayed until 6 weeks after the completion of radiotherapy, the percentage of atypical biopsies containing residual tumor rose from 21% to 55%. The posttreatment biopsy should be performed twice, as four patients had negative biopsy findings due to sampling error.
鼻咽癌是香港常见的恶性肿瘤，采用体外放射治疗。放疗6.5周后，对100例患者的鼻咽部进行检查并采集活检标本。所有患者每2周进行重复检查和活检，直至未见外生性肿瘤且鼻咽部多次检查的活检样本均为阴性。治疗结束至活检的间隔时间为1天至11周。23例患者有非典型表现，其中5例有残留肿瘤，需要进行金粒植入近距离放疗。我们在活检后材料中发现了一些明显的病理变化。这些变化大多在治疗结束8周后消失，但此时残留肿瘤的存在是后续治疗的指征。如果首次活检日期推迟到放疗结束后6周，含有残留肿瘤的非典型活检百分比从21%上升到55%。治疗后活检应进行两次，因为有4例患者因取样误差活检结果为阴性。
