Auxiliary examination methods for nasopharyngeal carcinoma

Nasopharyngeal carcinoma refers to a malignant tumor that occurs on the top and side walls of the nasopharyngeal cavity. It has the highest incidence rate among malignant tumors of the ear, nose and throat and is one of the most common malignant tumors in my country. With the rapid development of medical technology, more and more advanced equipment has been used to detect nasopharyngeal carcinoma.

So, what kind of examination should be done for nasopharyngeal cancer? Luoyang Jiuzhou Traditional Chinese Medicine Cancer Hospital has advanced diagnostic and treatment equipment and rich experience in diagnosis and treatment. Here are some examination methods for nasopharyngeal cancer:

1. Nasopharyngoscopy: 1. Indirect nasopharyngoscopy: This is a simple, fast and effective examination method; 2. Fiberoptic nasopharyngoscopy: This method is relatively simple, but the observation of the posterior nasal aperture and the anterior wall of the roof is not satisfactory. The posterior nasal aperture, nasal septum, posterior nasal cavity, lateral nasopharyngeal wall, Eustachian tube, lateral fossa, back and posterior wall of the soft palate can be observed.

2. Clinical examination: In addition to the examination of the nasopharynx, nasal cavity, and oropharynx, the head and face, regional lymph node metastasis, and all body systems must be examined for nasopharyngeal carcinoma. 1. Head and neck examination: The nasal cavity, oropharynx, external auditory canal, tympanic membrane, eye socket, and soft palate should be examined for outward extension of nasopharyngeal carcinoma. 2. Eyes: Common symptoms include decreased or absent vision, exophthalmos, intraorbital masses, and ptosis of the upper eyelid with fixed eyeballs. 3. Cranial nerves: Local extension of nasopharyngeal carcinoma often causes damage to the cranial nerves, which in turn causes various neurological disorders in the head and face.

3. X-ray examination: X-ray examination of nasopharyngeal carcinoma patients can help understand the tumor range and skull base bone destruction, which is helpful for staging nasopharyngeal carcinoma, formulating radiotherapy plans, following up patients and evaluating prognosis. Commonly used X-ray examinations include nasopharyngeal lateral film and skull base film.

4. Radionuclide bone imaging diagnosis: Radionuclide bone imaging diagnosis is a non-invasive and highly sensitive diagnostic method. It is generally believed that the positive coincidence rate of bone scan in diagnosing bone metastasis is 30% higher than that of X-ray film; and lesions can be detected 3-6 months earlier.

5. CT examination: CT examination of nasopharyngeal carcinoma can be used to understand the location of the tumor in the nasopharyngeal cavity, whether the lumen is deformed or asymmetric, and whether the pharyngeal recess is shallow or blocked. In addition, it can also show the invasion outside the nasopharyngeal cavity, such as the nasal cavity, oropharynx, parapharyngeal space, submental fossa, carotid sheath area, pterygopalatine fossa, maxillary sinus, ethmoid sinus, orbit, intracranial cavernous sinus, and whether there is metastasis in the posterior pharyngeal and cervical lymph nodes. Nasopharyngeal endoscopy has outstanding value in the diagnosis of tiny tumors in the cavity, while X-ray films and CT often cannot detect such tiny tumors. However, most of the posterior wall and lateral wall tumors grow submucosal infiltrates, which are difficult to be detected by nasopharyngeal endoscopy, but can be clearly displayed by lateral nasopharyngeal films and CT. CT shows lateral wall tumors more clearly than X-ray films.

6. Type B Ultrasound Examination: Type B Ultrasound Examination has been widely used in the diagnosis and treatment of nasopharyngeal carcinoma. It is simple, non-invasive and well-received by patients. In nasopharyngeal carcinoma cases, it is mainly used to examine the liver, cervical, retroperitoneal and pelvic lymph nodes to understand whether there is liver metastasis, lymph node density, cysticity, etc.

7. Magnetic resonance imaging: Magnetic resonance imaging (MRI) can clearly show all levels of the skull, cerebral grooves, gyri, gray matter, white matter, ventricles, cerebrospinal fluid ducts, blood vessels, etc., and the SE method can be used to display T1 and T2 extended high-intensity images to diagnose nasopharyngeal carcinoma, maxillary sinus cancer, etc., and to show the relationship between the tumor and the surrounding tissues. Since MRI can determine the tumor boundary more clearly and accurately, it is very useful for positioning the radiation field of radiotherapy. At the same time, MRI examination is very helpful in understanding brain damage after radiotherapy.

8. Serological diagnosis: Since the level of EB virus antibodies in the serum of NPC patients is very different from that of other malignant tumor patients and healthy people, it can be used as an auxiliary diagnosis method for NPC. It is mainly used for: 1. Patients with symptoms of NPC, such as retractile bloody nasal discharge, tinnitus, hearing loss, headache, cervical lymphadenopathy, facial numbness, diplopia, etc. 2. Patients with metastatic cancer confirmed by pathological biopsy of cervical lymphadenopathy or puncture of neck mass, to help find the primary lesion. 3. Serological epidemiological survey of people in areas with high incidence of NPC.

9. Pathological diagnosis: The final diagnosis of nasopharyngeal carcinoma is based on pathological diagnosis. Although clinical symptoms, signs, X-ray, CT and serological diagnosis suggest nasopharyngeal carcinoma, a clear pathological diagnosis is still required. There are several methods for taking biopsy tissues of nasopharyngeal carcinoma: 1. Oral bite biopsy (the most commonly used method). 2. Nasal pharyngeal biopsy through the nasal cavity. 3. Nasopharyngeal fine needle puncture.

10. Early diagnosis: Early diagnosis and early treatment are one of the most effective ways to improve the efficacy of tumor treatment. Early diagnosis can improve the treatment effect. The focus of nasopharyngeal cancer prevention and treatment is to vigorously strengthen the publicity of cancer prevention knowledge, so that the general public can know the early symptoms of nasopharyngeal cancer and seek medical treatment in time if symptoms occur.