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预测鼻咽癌诊断的流行病学和临床因素:成人与儿童人群。

Predictive epidemiological and clinical factors of nasopharyngeal carcinoma diagnosis: Adult versus pediatric population.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia 5100, Tunisia.

Pediatric Department, Tahar Sfar Hospital, Mahdia 5100, Tunisia.

出版信息

Int J Pediatr Otorhinolaryngol. 2020 Oct;137:110203. doi: 10.1016/j.ijporl.2020.110203. Epub 2020 Jul 3.

Abstract

OBJECTIVE

The objective of this study is to compare the clinical presentation and the cancer staging of nasopharyngeal carcinoma (NPC) between pediatric and adult populations to highlight the main characteristics of this disease within the two subgroups.

MATERIEL AND METHODS

It is a retrospective study including all patients with a primary diagnosis of NPC over a period of 19 years. The pediatric group included patients aged less then 16 years old.

RESULTS

A total of 80 patients were included. The pediatric population represented 22.5% of the cases. No difference in gender distribution was found (p˃.05). The most common presenting symptom was neck mass in children (77.8% vs. 48.4%, p = .02), and nasal obstruction in adult patients (64.5% vs. 16.7%, p < .01). The median time between the presenting symptom's onset and the diagnosis was 5 months. The diagnosis of NPC was delayed in pediatric patients compared to adults (<0.05). We noted a predominance of patients with stages III and IV (32.5% and 40%, respectively) with no difference between the two subgroups (p˃.05).

CONCLUSION

Our study showed some differences in NPC clinical features between pediatric patients and adults. Neck mass was the most common symptom in children. The initial presentation is sometimes misleading. NPC was mainly diagnosed in advanced locoregional stages in both pediatric and adult patients. Efforts toward early diagnosis are of great importance.

摘要

目的

本研究旨在比较儿童和成人鼻咽癌(NPC)的临床表现和癌症分期,以突出该疾病在两个亚组中的主要特征。

材料与方法

这是一项回顾性研究,纳入了 19 年来所有初次诊断为 NPC 的患者。儿科组包括年龄小于 16 岁的患者。

结果

共纳入 80 例患者。儿科患者占病例的 22.5%。两组患者的性别分布无差异(p˃.05)。儿童最常见的首发症状是颈部肿块(77.8%比 48.4%,p =.02),而成人患者则是鼻塞(64.5%比 16.7%,p ˂.01)。首发症状出现至确诊的中位时间为 5 个月。与成人相比,儿科患者的 NPC 诊断延迟(p<.05)。我们注意到 III 期和 IV 期患者占主导地位(分别为 32.5%和 40%),但两组间无差异(p>.05)。

结论

我们的研究表明,儿童和成人 NPC 的临床特征存在一些差异。颈部肿块是儿童最常见的症状。首发表现有时具有误导性。NPC 在儿科和成年患者中均主要诊断为局部晚期。早期诊断至关重要。

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