Do you know what tests should be done to confirm nasopharyngeal cancer?

Guangdong, Guangxi, Fujian, Hunan and other places in China are high-incidence areas for nasopharyngeal cancer, with more cases in males than females. Most of the patients are middle-aged, but some are teenagers. If a middle-aged person suddenly develops symptoms of persistent Eustachian tube occlusion on one side for unknown reasons, or bloody nasal discharge, or swollen lymph nodes in the neck, the first thing to think of is nasopharyngeal cancer. So what kind of examinations are needed to diagnose nasopharyngeal cancer?

1. General examination

First check the oral cavity, pharynx, hypopharynx and larynx. If there is no lesion, the nasopharynx should be carefully checked. The simplest method of nasopharyngeal examination is to use fingers to explore. This method does not require throat anesthesia and any equipment. During the examination, the fingers should be disinfected with alcohol and attention should be paid to whether the two sides of the nasopharynx are symmetrical and whether there are lumps. Because most nasopharyngeal carcinomas are prone to bleeding after being touched, the pharynx and fingers should be checked for blood after exploration. If there is a posterior rhinoscope, it is best to use it to examine the nasopharynx, carefully observe whether there is paralysis in the soft pharynx and pharynx, whether there are tumors and ulcers in the Eustachian tube, the top of the nasal cavity and the pharyngeal recess, and the symmetry of the two sides of the nasopharynx.

2. Cytological smear examination

The positive rate can reach about 70%. The method is to use a cotton cage to rub or a steel ring to scrape the nasopharyngeal secretions and look for cancer cells under the microscope.

3. Pathological section examination

Nasopharyngeal carcinoma often requires pathological examination for diagnosis. Most exophytic nasopharyngeal carcinoma biopsies are easy to remove. The simplest method is to use biopsy forceps to directly take tissue from the nasal cavity to the back and outside, or to use a pair of curved forceps placed behind the soft tongue and use fingers to guide to take tumor tissue from the top of the nasopharynx and the ulnar recess. For smaller tumors located in the Eustachian tube, tissue specimens need to be taken from the nasopharyngeal endoscope under the guidance of the posterior nasal endoscope.

4. X-ray examination

It is of certain significance for the diagnosis of nasopharyngeal carcinoma. Lateral X-rays can often reveal soft tissue enlargement of the posterior wall of the nasopharynx, and sometimes decalcification of the sphenoid sinus wall. Front-to-back X-rays of the skull can be used to observe the invasion of the ethmoid sinus, orbit, nasal cavity and superior sinus by the tumor. The most important thing is to observe whether the skull base is damaged through X-rays.

5. MRI

MRI examination is superior to CT examination in the diagnosis of nasopharyngeal carcinoma because it can show the relationship between the tumor and surrounding tissues and prevent artifacts.

6. CT examination

CT examination of nasopharyngeal carcinoma can understand the location of the tumor, whether the lumen is deformed or asymmetric, whether the pharyngeal recess is shallow or blocked, and whether there is any invasion outside the nasopharyngeal cavity, such as the nasal cavity, oropharynx, parapharyngeal space, subfacial fossa, pterygoid fossa, cleft sinus, ethmoid sinus, orbit, carotid artery area, intracranial cavernous sinus, posterior pharynx, and cervical lymph node metastasis, etc. It is of great significance for the diagnosis of early nasopharyngeal carcinoma.

7. Ultrasound examination

B-ultrasound has been widely used in the diagnosis and treatment of nasopharyngeal carcinoma, mainly for the examination of the neck, liver, abdomen and pelvic lymph nodes to determine whether there is metastasis.

8. Serological examination

After EB virus is infected by human body and enters cells, different antigens and corresponding antibodies are produced in different stages of virus replication cycle. Since the serum EB virus antibody level of NPC patients is significantly different from that of other tumor patients and healthy people, it can be used as an auxiliary diagnosis method for NPC.

Through the above explanation, we know some of the tests that need to be performed to diagnose nasopharyngeal carcinoma. I believe that everyone has a certain understanding of how to diagnose nasopharyngeal carcinoma. I hope this article can help you or your friends. This article is for reference only. If you have other questions, please consult our experts online.

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