Methods for routine examination of nasopharyngeal carcinoma

Nasopharyngeal cancer has become a disease of the five senses that many friends will talk about at gatherings. It can be seen that nasopharyngeal cancer has become a disease of concern to the public. The key to the prevention and treatment of nasopharyngeal cancer lies in treatment. So how to diagnose and examine nasopharyngeal cancer? Let's learn about it together.

1. Posterior rhinoscopy

It is convenient and easy to perform. Small nodules or granuloma-like protrusions can be seen in the pharyngeal recess and the anterior wall of the nasopharyngeal roof. The surface is rough and uneven, easy to bleed, and sometimes appears as submucosal protrusions. When the early lesions are atypical, they may only show mucosal congestion, vascular distension, or a fuller pharyngeal recess on one side, which requires attention.

2. Fiberoptic nasopharyngeal endoscopy

It is helpful for discovering early tiny lesions, especially for patients with strong pharyngeal reflex or difficulty opening their mouth. If suspicious lesions are found, biopsy should be performed in time.

3. EB virus serological test

As an auxiliary indicator for the diagnosis of nasopharyngeal carcinoma, Epstein-Barr virus capsid antigen, Epstein-Barr virus early antigen, Epstein-Barr virus nuclear antigen, etc. can be tested.

4. Exfoliated cell examination

Generally, under local anesthesia, a specimen is taken from the nasopharynx using foam plastic, sponge or negative pressure suction to make a smear to check for cancer cells. The detection rate can reach about 90%, which is close to that of a biopsy. Exfoliative cytology combined with serology can be used for general screening.

5. Biopsy

It is the basis for the diagnosis of nasopharyngeal carcinoma. A bite biopsy is taken under open vision through the nasal cavity or oropharyngeal approach. For submucosal protrusions, a puncture needle can be used to obtain submucosal tumor tissue for pathology.

6. Palpation and biopsy of cervical lymph nodes

Hard, poorly mobile or immobile, painless and enlarged lymph nodes can be felt deep in the neck. If the patient has enlarged cervical lymph nodes, but no obvious suspicious lesions are found in the nasopharyngeal examination, and multiple nasopharyngeal biopsies are negative, a neck mass biopsy can be considered for diagnosis. Usually, the neck mass is punctured and aspirated for cytological examination. If necessary, the neck mass can be cut open and tissue can be taken for examination. It is best to select a single enlarged lymph node, remove it all, and perform pathological examination to prevent the spread of cancer. According to its pathological type, the primary lesion can be determined.

7. Imaging examination

CT and MRI examinations are helpful in understanding the extent of tumor invasion and the degree of skull base bone destruction. PET-CT or PET-MRI examinations can be performed if conditions permit.