Spirin D S, Kobyakov G L, Cherekaev V A, Nazarov V V, Kadasheva A B, Vetlova E R, Gordon K V
Burdenko Neurosurgical Institute, Moscow, Russia.
A.F. Tsyb Medical Radiology Research Center - Branch of National Medical Radiology Research Center of Ministry of Health of Russia, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2016;80(3):106-113. doi: 10.17116/neiro2016803106-113.
A review of literature presents up-to-date information on the prevalence, incidence, clinical manifestations, diagnosis, and classification of malignant primary skull base tumors (MPSBTs). In the structure of total cancer incidence, malignant head and neck tumors account for 5% of all annual cancer deaths in the USA and are among the 5 most common groups of tumors in males worldwide. These tumors develop most often in the sixth decade of life, occurring 2 times more often in males than in females. In Russia, the MPSBT incidence (as of 2012) was 0.62% out of all newly diagnosed malignant tumors. The incidence rate amounts to 0.66 per 100 000 population and is significantly higher than the global rate (0.44 per 100 000). About half of all malignant skull base tumors have the epithelial nature and affect the anterior parts of the skull base. The most frequent histological types of malignant skull base tumors are squamous cell carcinoma, adenocarcinoma, and non-Hodgkin's B cell lymphoma. Treatment of skull base tumors is an interdisciplinary problem and the area of interest of otolaryngologists, dentists, ophthalmologists, neurosurgeons, plastic surgeons, radiologists, and chemotherapists. Physical and endoscopic examinations, endoscopic transnasal biopsy, CT, MRI, PET/CT, and ultrasound are typically used for verification of the diagnosis, tumor staging, and selection of the treatment approach. The review describes the criteria for TNM staging of malignant tumors of the nasal cavity and paranasal sinuses in accordance with the 7th version of the TNM recommendations of the American Joint Committee on Cancer (AJCC). The TNM-based staging depends on the location (maxillary sinus, nasal cavity, or ethmoid labyrinth) and histological structure of the tumor, which, in turn, determines the tactics of comprehensive treatment and a prognosis group.
一篇文献综述提供了有关原发性恶性颅底肿瘤（MPSBTs）的患病率、发病率、临床表现、诊断和分类的最新信息。在所有癌症发病率结构中，恶性头颈肿瘤占美国每年癌症死亡总数的5%，是全球男性中最常见的5类肿瘤之一。这些肿瘤最常发生在生命的第六个十年，男性发病频率是女性的2倍。在俄罗斯，MPSBT的发病率（截至2012年）在所有新诊断的恶性肿瘤中占0.62%。发病率为每10万人0.66例，显著高于全球发病率（每10万人0.44例）。所有恶性颅底肿瘤中约一半具有上皮性质，且累及颅底前部。恶性颅底肿瘤最常见的组织学类型是鳞状细胞癌、腺癌和非霍奇金B细胞淋巴瘤。颅底肿瘤的治疗是一个跨学科问题，是耳鼻喉科医生、牙医、眼科医生、神经外科医生、整形外科医生、放射科医生和化疗医生关注的领域。体格检查和内镜检查、内镜经鼻活检、CT、MRI、PET/CT和超声通常用于诊断验证、肿瘤分期和治疗方法的选择。该综述根据美国癌症联合委员会（AJCC）TNM推荐的第7版描述了鼻腔和鼻窦恶性肿瘤的TNM分期标准。基于TNM的分期取决于肿瘤的位置（上颌窦、鼻腔或筛迷路）和组织结构，这反过来又决定了综合治疗策略和预后分组。
