What are the diagnostic methods for nasopharyngeal carcinoma?

In recent years, nasopharyngeal carcinoma has become one of the major diseases that endangers society and human health, and it has brought great pain and distress to mankind. Nasopharyngeal carcinoma is a common malignant tumor in my country, and its mortality rate ranks among the top among cancers. The incidence of nasopharyngeal carcinoma in my country ranks first in the world. What are the diagnostic methods for nasopharyngeal carcinoma?

1. Nasopharyngeal endoscopy

(1) Indirect nasopharyngeal endoscopy: 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 nasal cavity 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, etc. can be observed.

2. Clinical Examination

In addition to examining the nasopharynx, nasal cavity, and oropharynx, nasopharyngeal carcinoma also requires examination of the head and face, regional lymph nodes for metastasis, and all body systems.

(1) Head and neck examination: The nasal cavity, oropharynx, external auditory canal, tympanic membrane, eye socket, and soft palate should be examined for any outward extension of nasopharyngeal carcinoma.

(2) Eyes: Common symptoms include decreased or absent vision, exophthalmos, orbital masses, and ptosis of the upper eyelid with fixed eyeballs.

(3) Cranial nerves: Local extension of nasopharyngeal carcinoma often causes damage to cranial nerves, leading to various neurological disorders in the head and face.

3. X-ray examination

X-ray examinations of nasopharyngeal carcinoma patients can help understand the extent of the tumor and the destruction of the skull base bones, which is beneficial for the staging of nasopharyngeal carcinoma, formulation of radiotherapy plans, follow-up of patients and evaluation of prognosis. Commonly used X-ray examinations include nasopharyngeal lateral films and skull base films.

4. Radionuclide bone imaging diagnosis

Radionuclide bone imaging 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 help us 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 find such tiny tumors; however, most of the posterior wall and lateral wall tumors grow submucosal infiltrates, which are difficult to be found by nasopharyngeal endoscopy, but can be clearly shown by lateral nasopharyngeal films and CT. CT shows lateral wall tumors more clearly than X-ray films.

6. B-mode Ultrasound Examination

B-mode ultrasound examination has been widely used in the diagnosis and treatment of nasopharyngeal carcinoma. It is simple, non-invasive and well accepted by patients. In nasopharyngeal carcinoma cases, it is mainly used to examine the liver, neck, retroperitoneum and pelvic lymph nodes to understand whether there is liver metastasis and lymph node density, whether there is cysticity, etc.

7. Magnetic resonance imaging

Since 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., 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 there is a very obvious difference between the EB virus antibody level in the serum of NPC patients and other malignant tumor patients and healthy people, it can be used as an auxiliary diagnosis method for NPC. Mainly used in:

(1) Patients with symptoms of nasopharyngeal cancer, such as retractile bloody mucus, tinnitus, hearing loss, headache, swollen cervical lymph nodes, facial numbness, diplopia, etc.;

(2) For patients with cervical lymph node enlargement confirmed by pathological biopsy or cervical mass puncture as metastatic cancer, it helps to find the primary lesion;

(3) Serological epidemiological survey of the population in areas with a 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 definitive pathological diagnosis is still required. There are several methods for taking biopsies of nasopharyngeal carcinoma:

(1) Oral bite biopsy (most commonly used method)

(2) Transnasal nasopharyngeal biopsy

(3) Fine needle aspiration of the nasopharynx

10. Differential Diagnosis

An auxiliary diagnostic method for comparison with various types of lesions.

11. 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.

The above is the knowledge about the diagnosis of nasopharyngeal carcinoma. Experts suggest: If you have symptoms of disease, you should go to a regular hospital for treatment in time to avoid delaying the disease and causing serious consequences. If you have other questions, please consult our online experts or call for consultation. Believe in miracles and wish you health, happiness and joy!

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