Dixit S, Upadhyaya C, Humagain M, Srii R, Marla V
Department of Dentistry, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
College of Dental Surgery, BP Koirala Institute of Health Sciences, Dharan Nepal.
Kathmandu Univ Med J (KUMJ). 2016 Apr-Jun;14(54):167-171.
Background Head and neck is one of the most prevalent site for cancers along with lungs, cervix, breast and stomach. Hospital based cancer registries required for effective evaluation of diagnosis and management of cancer is inadequate in Nepal. Cancer registry system established by WHO is acquired by seven major hospitals in our country. However, data from tertiary health care centres like ours remain undocumented. Objective The objective of this study is to perform retrospective analysis of clinicohistopathological types of head and neck lesions which were eventually diagnosed as cancer in Dhulikel Hospital, a tertiary health care centre of Central East Nepal. Method Data regarding head and neck lesions diagnosed as cancer (January 2001- December 2014) were extracted from the archives of Department of General Pathology. These cases were categorised according to demographic profile, site of cancer and histological diagnosis. Result A total of 240 cases matched the inclusion criteria and were selected for this study. Male: Female ratio of 1.3:1 with a mean age of 52 years (52.82±1.8) was found. Two hundred and two (84.16%) patients were diagnosed with carcinoma, 31 (15%) with lymphoma, 3 (1.25%) with melanoma, 2(0.83%) with small round cell tumor and 2 (0.83%) with sarcoma. The most common histological types of carcinoma seen were Squamous cell carcinoma (138 cases; 57.5%) followed by papillary carcinoma (26 cases; 10.8%). Among the lymphomas Non-Hodgkin's lymphoma (21 cases; 8.75%) was the most predominant type. The most common site of presentation was oral cavity (60 cases; 25%) followed by skin (36 cases; 15%), thyroid (32 cases; 13.33%) and oesophagus (27 cases; 11.25%). Metastasis to cervical lymph node was found in 39 cases (16.25%). Conclusion Based on these finding, it was observed that Squamous cell carcinoma was the most common type followed by different epithelial and mesenchymal malignancies in head and neck region. The results revealed by this study will provide useful information for planning the health care policies about cancer in Nepal and will be more effective and helpful to the patients of remote areas.
头颈部是癌症最常见的发病部位之一,与肺癌、宫颈癌、乳腺癌和胃癌一样。在尼泊尔,基于医院的癌症登记对于有效评估癌症的诊断和治疗是不够的。世界卫生组织建立的癌症登记系统已被我国七家主要医院采用。然而,像我们这样的三级医疗中心的数据仍未记录在案。目的:本研究的目的是对尼泊尔中东部三级医疗中心杜利凯尔医院最终诊断为癌症的头颈部病变的临床组织病理学类型进行回顾性分析。方法:从普通病理学系档案中提取2001年1月至2014年12月诊断为癌症的头颈部病变数据。这些病例根据人口统计学特征、癌症部位和组织学诊断进行分类。结果:共有240例符合纳入标准并被选入本研究。发现男女比例为1.3:1,平均年龄为52岁(52.82±1.8)。202例(84.16%)患者被诊断为癌,31例(15%)为淋巴瘤,3例(1.25%)为黑色素瘤,2例(0.83%)为小圆细胞瘤,2例(0.83%)为肉瘤。最常见的癌组织学类型是鳞状细胞癌(138例;57.5%),其次是乳头状癌(26例;10.8%)。在淋巴瘤中,非霍奇金淋巴瘤(21例;8.75%)是最主要的类型。最常见的发病部位是口腔(60例;25%),其次是皮肤(36例;15%)、甲状腺(32例;13.33%)和食管(27例;11.25%)。39例(16.25%)发现有颈部淋巴结转移。结论:基于这些发现,观察到头颈部区域鳞状细胞癌是最常见的类型,其次是不同的上皮和间叶恶性肿瘤。本研究结果将为尼泊尔制定癌症医疗保健政策提供有用信息,对偏远地区的患者将更有效且有帮助。