Wai Pak Martin, To Ka Fai, Lee Joseph Chuen Kwun, Liang Eisen Yee, van Hasselt Charles Andrew
Division of Otorhinolaryngology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, SAR, China.
Head Neck. 2005 Nov;27(11):1008-13. doi: 10.1002/hed.20281.
Nasopharyngeal dysplasia or nasopharyngeal carcinoma in situ (NPCIS) lesions have rarely been reported. Timely diagnosis of the preinvasive lesion may improve prognosis. Contact endoscopy has been documented to accurately differentiate normal cells of the nasopharynx from malignant cells and allows a real-time diagnosis of primary and recurrent nasopharyngeal carcinoma (NPC) in a clinical setting. However, the role of contact endoscopy in the diagnosis of NPCIS is unknown.
The superficial cells of the nasopharynx in a patient with NPCIS were examined in vivo under local anaesthesia by use of a contact rhinoscope. The contact endoscopic findings were correlated with the histologic findings of the biopsy.
The atypical cells of the lesion were magnified and visualized under contact endoscopy. Histopathologic analysis of the biopsied tissue confirmed the presence of NPCIS staining positively for Epstein-Barr virus (EBV)-encoded RNA (EBER). No cell-free EBV DNA was detected in the sera of the patient.
Contact endoscopy can accurately identify the atypical cells of a tiny preinvasive lesion in the nasopharynx in a clinical setting, which may not be evident in routine imaging examination.
鼻咽发育异常或鼻咽原位癌（NPCIS）病变鲜有报道。对癌前病变的及时诊断可能改善预后。接触式内镜已被证明能准确区分鼻咽正常细胞与恶性细胞，并能在临床环境中对原发性和复发性鼻咽癌（NPC）进行实时诊断。然而，接触式内镜在NPCIS诊断中的作用尚不清楚。
在局部麻醉下，使用接触式鼻内镜对一名NPCIS患者的鼻咽表层细胞进行体内检查。将接触式内镜检查结果与活检的组织学结果进行关联。
在接触式内镜下，病变的非典型细胞被放大并可视化。对活检组织的组织病理学分析证实存在NPCIS，对爱泼斯坦-巴尔病毒（EBV）编码RNA（EBER）染色呈阳性。在该患者血清中未检测到游离EBV DNA。
接触式内镜可在临床环境中准确识别鼻咽微小癌前病变的非典型细胞，而这在常规影像学检查中可能并不明显。
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