Parker J T, Hill J H
Department of Otolaryngology-Head and Neck Surgery, University of Illinois College of Medicine, Chicago.
Laryngoscope. 1988 Feb;98(2):147-9. doi: 10.1288/00005537-198802000-00005.
The entire upper aerodigestive tract must be evaluated at the time of initial tumor evaluation in patients with squamous cell carcinoma of the head and neck. The necessity of panendoscopy (laryngoscopy, bronchoscopy, esophagoscopy) in this evaluation has not been demonstrated convincingly. Between January 1, 1984 and December 31, 1985, 208 patients with previously untreated squamous cell carcinoma of the head and neck were analyzed prospectively. These patients underwent head and neck examination, chest radiograph, barium esophagram, and panendoscopy. Fifteen (7.2%) had synchronous malignancies of the upper aerodigestive tract. In four patients (1.9%) the synchronous primary tumor was found only by endoscopy. Three patients (1.4%) had cancers of the hypopharynx. One patient (0.5%) had a bronchial cancer detected only on bronchoscopy. No tumors were detected by esophagoscopy that were not also seen on barium esophagram. We conclude that endoscopic examination of the hypopharynx is very helpful in screening for additional tumors in head and neck cancer patients, but routine esophagoscopy cannot be supported. Screening bronchoscopy cannot be strongly supported due to its very low yield.
对于头颈部鳞状细胞癌患者，在初次肿瘤评估时必须对整个上消化道进行评估。在这种评估中，全内镜检查（喉镜检查、支气管镜检查、食管镜检查）的必要性尚未得到令人信服的证实。在1984年1月1日至1985年12月31日期间，对208例先前未经治疗的头颈部鳞状细胞癌患者进行了前瞻性分析。这些患者接受了头颈部检查、胸部X光片、食管钡餐造影和全内镜检查。15例（7.2%）患者存在上消化道同步恶性肿瘤。4例患者（1.9%）的同步原发性肿瘤仅通过内镜检查发现。3例患者（1.4%）患有下咽癌。1例患者（0.5%）仅在支气管镜检查时发现支气管癌。食管镜检查未发现食管钡餐造影未显示的肿瘤。我们得出结论，下咽的内镜检查对于筛查头颈部癌症患者的其他肿瘤非常有帮助，但常规食管镜检查无法得到支持。由于其检出率极低，筛查支气管镜检查也无法得到有力支持。
