Huang Chi-Che, Chang Po-Hung, Lee Ta-Jen, Chuang Chi-Cheng, Chang Joseph Tung-Chieh
Department of Otolaryngology--Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, 333, Taiwan.
Am J Otolaryngol. 2009 Sep-Oct;30(5):300-4. doi: 10.1016/j.amjoto.2008.06.014. Epub 2008 Oct 11.
The objective of this study was to evaluate the incidence and the possible risk factors for preirradiation abnormalities of the sinus mucosa in patients with nasopharyngeal carcinoma (NPC) by magnetic resonance imaging.
Medical records and magnetic resonance imaging results were reviewed and compared between a group of patients with NPC and a control group. The Lund-Mackay system for staging of rhinosinusitis (Lund score) was used as a tool for the investigation.
The incidence of sinus mucosal abnormalities was 32.1% in the NPC group and 20.7% in the control group (P = .041). The patients with NPC demonstrated a higher incidence of sinus abnormalities in nearly all sinuses. However, only the incidence of disease in the posterior ethmoid (P = .002) and sphenoid sinus (P = .006) was significantly increased in patients with NPC. The incidence and the severity of sinus abnormalities in male patients with NPC were significantly higher than that in female patients. Patients with advanced T stage showed significantly higher Lund scores (P = .015) than patients with early T stage.
The results supported the hypothesis that patients with NPC might be prone to have chronic infection and might be partially immunocompromised by Epstein-Barr virus. Female patients may have an inherited genetic advantage that protects against Epstein-Barr virus infection or lessens its devastating effects.
本研究的目的是通过磁共振成像评估鼻咽癌(NPC)患者放疗前鼻窦黏膜异常的发生率及可能的危险因素。
回顾并比较一组鼻咽癌患者和对照组的病历及磁共振成像结果。采用用于鼻窦炎分期的伦德-麦凯系统(伦德评分)作为调查工具。
鼻咽癌组鼻窦黏膜异常的发生率为32.1%,对照组为20.7%(P = 0.041)。鼻咽癌患者几乎在所有鼻窦中鼻窦异常的发生率都更高。然而,仅筛窦后部(P = 0.002)和蝶窦(P = 0.006)疾病的发生率在鼻咽癌患者中显著增加。男性鼻咽癌患者鼻窦异常的发生率和严重程度显著高于女性患者。T分期较晚的患者的伦德评分显著高于T分期较早的患者(P = 0.015)。
结果支持以下假设,即鼻咽癌患者可能易于发生慢性感染,并且可能因爱泼斯坦-巴尔病毒而部分免疫功能受损。女性患者可能具有遗传优势,可预防爱泼斯坦-巴尔病毒感染或减轻其破坏性影响。