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鼻咽部检查及活检在恶性疾病诊断中的作用。

The role of nasopharyngeal examination and biopsy in the diagnosis of malignant diseases.

作者信息

Arslan Necmi, Tuzuner Arzu, Koycu Alper, Dursun Songul, Hucumenoglu Sema

机构信息

University of Health Sciences, Ankara Training and Research Hospital, Department of Otolaryngology, Head and Neck Surgery, Ankara, Turkey.

Baskent University Hospital, Department of Otolaryngology, Head and Neck Surgery, Ankara, Turkey.

出版信息

Braz J Otorhinolaryngol. 2019 Jul-Aug;85(4):481-485. doi: 10.1016/j.bjorl.2018.04.006. Epub 2018 May 15.

Abstract

INTRODUCTION

In direct proportion to the increasing rate of nasopharynx examinations applied, the early diagnosis and treatment of lesions in this region is possible. At times the clinical findings and the biopsy results are not consistent, so biopsies may have to be repeated.

OBJECTIVES

The aim of this study was to evaluate the distribution of pathology test results obtained from cases of nasopharynx biopsy, to determine with which methods determination most often was made, and to investigate which kinds of cases required the biopsy to be repeated.

METHODS

The study included a total of 1074 patients (500 female, 574 male) who underwent nasopharyngeal biopsy in our clinic between June 2011 and June 2017. Data were obtained from patient records of age, gender, clinical findings, imaging findings if available and pathological diagnosis. The pathological diagnoses were separated into 3 main groups as chronic nasopharyngitis, benign cytology and malignant cytology.

RESULTS

The examinations resulted in 996 cases reported as chronic nasopharyngitis, 47 as benign cytology and 31 as malignant cytology. Of the 31 malignant lesions, diagnosis was made in 15 patients (48.4%) with a single biopsy, and in 16 patients (51.6%), as a result of the pathology report when 2 or more biopsies were taken. In the comparison of the benign and malignant lesions in respect of the need for repeated biopsies, the cases determined with malignancy were found to have a statistically significantly higher rate of repeated biopsy (p<0.001).

CONCLUSION

In comparison with cases of benign tumor, a statistically significantly greater number of repeated biopsies were required in cases diagnosed as malignant tumors to confirm the pathological diagnosis or when there was continued suspicion of malignancy. Therefore, when there is clinical suspicion, even if there are no findings of malignancy on the first biopsy, the biopsy should be repeated expeditiously.

摘要

引言

随着鼻咽部检查应用率的不断提高,该区域病变的早期诊断和治疗成为可能。有时临床发现与活检结果不一致,因此可能需要重复活检。

目的

本研究旨在评估鼻咽活检病例的病理检查结果分布,确定最常采用的诊断方法,并调查哪些病例需要重复活检。

方法

本研究纳入了2011年6月至2017年6月期间在我院接受鼻咽活检的1074例患者(500例女性,574例男性)。数据来自患者的年龄、性别、临床发现、影像学检查结果(如有)及病理诊断记录。病理诊断分为慢性鼻咽炎、良性细胞学和恶性细胞学3个主要组。

结果

检查结果显示,996例报告为慢性鼻咽炎,47例为良性细胞学,31例为恶性细胞学。在31例恶性病变中,15例患者(48.4%)通过单次活检确诊,16例患者(51.6%)在进行2次或更多次活检后,根据病理报告确诊。在比较良性和恶性病变重复活检的必要性时,发现恶性病变患者重复活检的比例在统计学上显著更高(p<0.001)。

结论

与良性肿瘤病例相比,诊断为恶性肿瘤的病例为确诊病理诊断或持续怀疑恶性时,需要重复活检的数量在统计学上显著更多。因此,当临床上有怀疑时,即使首次活检未发现恶性迹象,也应尽快重复活检。

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