鼻咽癌专题知识讲座培训课件

鼻咽癌专题知识讲座鼻咽癌专题知识讲座2一、概述(outline)1.发病有一定的地区性(morecommoninsouth-eastAsiaintheworld,morecommoninsouthernChina)

我国头颈恶性肿瘤之冠(thetopofthemalignanttumorinheadandneck)。某些高发区可能为全身恶性肿瘤之首，广东、广西、湖南和福建高发。

鼻咽癌专题知识讲座32、高发年龄（maximumageincidence)：40~60岁（86.62%）3.性别(sex)：男多于女(maletofemaleis2:1)鼻咽癌专题知识讲座4二、病因(etiology)

(threepossiblecausalfactors)1.遗传因素(geneticfactors)种族易感性家族聚集性(racialpredilection,familytendencyandHLAtyping)

鼻咽癌专题知识讲座52.病毒因素----Epstein-BarrvirusEB病毒NPC患者血清中检测到EB病毒相关抗体(patientswithNPChavehighlevelofantibodyagainstEBV(over90%ofpatients)，NPC活组织的癌细胞中存在EBVDNA特异性mRNA或基因表达产物(expressionofgeneproducts，(butwhethertherelationshipbetweenthetwoiscausalorincidentalisstillunknown)鼻咽癌专题知识讲座63.环境因素(environmentfactors)

微量元素(microelement)：镍(nickel)

维生素缺乏(vitaminlack)

性激素失调(hormonalfactors)

亚硝胺Acombinationofgenetic,virusandenvironmentalinfluenceswouldbestexplaintheoccurrenceofnasopharyngealcarcinoma)鼻咽癌专题知识讲座7病理学(pathology)主要为低分化鳞癌。

少见腺癌、肉瘤等

Over95%Squamouscellcarcinoma(poorlydifferentiation)Adenocarcinoma,sarcoma,

鼻咽癌专题知识讲座8好发部位

mosttumorsariseontheposterosuperiorwallorfossaofRosenmuller

图咽隐窝鼻咽顶后壁鼻咽癌专题知识讲座9临床表现

(clinicalmanifestations)1、鼻部症状:涕血或后吸涕带血，鼻塞。nasalsymptomssuchasepistaxis,bloodypostnasaldischarge,nasalobstruction2.耳部症状：分泌性中耳炎Secretoryotitismedia:conductivedeafness,fluidinthemiddleear,tympanicmembraneindrawn鼻咽癌专题知识讲座10鼻咽癌专题知识讲座12颈淋巴转移图鼻咽癌专题知识讲座13鼻咽癌专题知识讲座144.颅神经症状:（图）involvedcranialnerves:fifthandsixthnervearethemostfrequentlyinvolved,Headache,internalstrabismus.4th,3rdand2ndcranialnervesarenextmostcommonlyaffected.9th,10th11thand12thmayalsobeinvolved鼻咽癌专题知识讲座15

舌下神经麻痹外展神经麻痹Hypoglossalparalysisabducensparalysis鼻咽癌专题知识讲座165.远处转移：Distantmetastasesoccurtobone,lung,liverandothersites鼻咽癌专题知识讲座17诊断(Diagnosis)1.病史、症状和体征History,symptomsandsignsEarlysymptoms:bloodypostnasaldischargefluidinthemiddleear(unilateral)鼻咽癌专题知识讲座182、鼻咽镜检查TheposteriorrhinoscopyFibreopticnasopharyngoscopy3.血清学检查EBVCA-IgA,EBVEA-IgG鼻咽癌专题知识讲座194.影象学检查ImagingCT,MRI鼻咽癌专题知识讲座205.鼻咽活检——确诊的方法Definitivediagnosisismadebybiopsy鼻咽癌专题知识讲座21鉴别诊断图鼻咽癌专题知识讲座22治疗(Treatment)放射治疗:Radiotherapyisthemethodofchoice.Prognosis:theoverall5-yearsurvivalrateisabout50%ran