Lee C-C, Ho H-C, Su Y-C, Lee M-S, Hsiao S-H, Hwang J-H, Hung S-K, Chou P, Lee C-C
Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Clin Otolaryngol. 2009 Feb;34(1):26-33. doi: 10.1111/j.1749-4486.2008.01839.x.
To determine whether the standard techniques of measuring tumour size could be applied to the measurement of nasopharyngeal carcinoma.
A retrospective review of case notes from the Buddhist Tzu Chi Dalin General Hospital archives was performed.
The Buddhist Tzu Chi Dalin General Hospital is a teaching hospital in Taiwan.
All patients with nasopharyngeal carcinoma were included.
Ninety-eight patients with newly diagnosed nasopharyngeal carcinoma were treated with high-dose radiotherapy and chemotherapy were enrolled in this study. Computed tomography-derived primary tumour volume, bidimensional measurement and unidimensional measurement were recorded. Intrarater reliability was measured. To examine the validity of various measurements, we estimated the Spearman's correlation co-efficients between those measurements and the gold standard value (primary tumour volume measurement with summation of area techniques). Univariate and multivariate analyses were performed and Kaplan-Meier survival curves constructed.
There was a significant association between primary tumour volume and bidimensional measurement with respect to tumour size at diagnosis (Spearman's correlation co-efficient = 0.845, P < 0.001). Using age, gender, chemotherapy status and T-stage as covariate, bidimensional measurement remained an independent prognostic factor for any relapse [Hazard ratio = (HR) 1.066; P = 0.029], and overall survival (HR = 1.097; P = 0.007). Patients with small bidimensional measurement (<10 cm(2)) had better prognosis and fewer recurrences.
When using simple measurement to evaluate nasopharyngeal carcinoma, the bidimensional measurement may be used to measure size at diagnosis. Patients with small bidimensional measurement had better prognosis and fewer recurrences. Bidimensional measurement may be further considered to improve the current staging system.
确定测量肿瘤大小的标准技术是否可应用于鼻咽癌的测量。
对佛教慈济大林综合医院档案中的病例记录进行回顾性研究。
佛教慈济大林综合医院是台湾的一家教学医院。
纳入所有鼻咽癌患者。
本研究纳入了98例新诊断的鼻咽癌患者，这些患者接受了高剂量放疗和化疗。记录计算机断层扫描得出的原发肿瘤体积、二维测量值和一维测量值。测量了评估者内部信度。为检验各种测量方法的有效性，我们估计了这些测量值与金标准值（采用面积求和技术测量的原发肿瘤体积）之间的斯皮尔曼相关系数。进行了单因素和多因素分析，并构建了Kaplan-Meier生存曲线。
在诊断时，原发肿瘤体积与二维测量值之间在肿瘤大小方面存在显著相关性（斯皮尔曼相关系数 = 0.845，P < 0.001）。以年龄、性别、化疗状态和T分期作为协变量，二维测量值仍然是任何复发的独立预后因素[风险比 = (HR) 1.066；P = 0.029]，以及总生存的独立预后因素（HR = 1.097；P = 0.007）。二维测量值较小（<10 cm²）的患者预后较好且复发较少。
在使用简单测量方法评估鼻咽癌时，二维测量值可用于测量诊断时的肿瘤大小。二维测量值较小的患者预后较好且复发较少。可进一步考虑二维测量值以改进当前的分期系统。
