【摘要】： 我國(guó)鼻咽癌患者約占全世界的80%,廣東省是鼻咽癌的高發(fā)地區(qū)之一,嚴(yán)重影響該地區(qū)人民健康,病理診斷是鼻咽癌確診的金標(biāo)準(zhǔn),病檢給疑似鼻咽癌患者帶來(lái)不必要的痛苦,本研究通過(guò)收集鼻咽癌高發(fā)區(qū)經(jīng)過(guò)醋酸染色的病人資料,為提高鼻咽癌活檢準(zhǔn)確性和陽(yáng)性率做出一定的貢獻(xiàn)。 研究目的：本研究旨在探討醋白反應(yīng)對(duì)疑似鼻咽癌患者是否需要活檢及活檢部位選取的臨床意義。 研究方法：病例來(lái)源于鼻咽癌高發(fā)區(qū)廣州中醫(yī)藥大學(xué)附屬中山市中醫(yī)院耳鼻喉科門(mén)診就診的患者,時(shí)間從2007年9月～2009年6月共189例,包括鼻咽癌19例,年齡24歲到75歲,平均年齡47.3歲,男15例,女4例；鼻咽上皮異型化生者16例,年齡25歲到56歲,平均年齡38.9歲,男9例,女7例；鼻咽炎47例,年齡19歲到62歲,平均年齡39.9歲,男20例,女27例。對(duì)照人群共107例,為健康志愿者,年齡14歲到82歲,平均年齡38.1歲,男60例,女47例。以2%醋酸溶液涂于鼻咽部病變區(qū),分別于即時(shí)、1分鐘后在纖維喉鏡下觀察鼻咽部粘膜的著色情況并采集圖像供分析,同時(shí)也對(duì)部分病人的舌象進(jìn)行了收集整理分析。 結(jié)果：不同鼻咽疾病出現(xiàn)不同程度的醋白反應(yīng),依病理惡性程度的增加醋白反應(yīng)呈增強(qiáng)反應(yīng),鼻咽癌、鼻咽炎伴上皮化生者,其醋白反應(yīng)陽(yáng)性率分別為：89.5%、93.8%、而鼻咽炎及健康志愿者二組人群未出現(xiàn)明顯的醋白反應(yīng),其醋白反應(yīng)陽(yáng)性率分別為：38.3%、4.7%。x2=115.2,p0.001。正常舌在健康對(duì)照者較多,占了總?cè)藬?shù)的50%,而鼻咽炎及伴化生者相對(duì)要少,而鼻咽癌組最少,只有28.5%。而病理舌象(舌淡及舌紅)在鼻咽癌、鼻咽炎及伴化生者相對(duì)增多,而在健康對(duì)照者相對(duì)減少。 結(jié)論：鼻咽內(nèi)鏡下醋白反應(yīng)對(duì)鼻咽上皮細(xì)胞癌變有一定的診斷價(jià)值,醋白反應(yīng)可用于指導(dǎo)鼻咽可疑病變的初步臨床判斷,以決定是否需要活檢及確定相對(duì)較準(zhǔn)確的活檢部位,最終提高鼻咽癌病檢的準(zhǔn)確性和陽(yáng)性率。
[Abstract]:The number of NPC patients in China accounts for about 80% of the world. Guangdong Province is one of the areas with high incidence of NPC, which seriously affects the health of the people in this region. Pathological diagnosis is the gold standard for the diagnosis of nasopharyngeal carcinoma, and the examination of the disease causes unnecessary suffering to suspected NPC patients. In order to improve the accuracy and positive rate of nasopharyngeal carcinoma biopsy, we collected the data of patients with high incidence of nasopharyngeal carcinoma after acetic acid staining. Objective: to investigate the clinical significance of vinegar-white reaction in patients with suspected nasopharyngeal carcinoma (NPC). Methods: the patients were selected from the otolaryngology clinic of Zhongshan traditional Chinese Medicine Hospital affiliated to Guangzhou University of traditional Chinese Medicine in the high incidence area of nasopharyngeal carcinoma. From September 2007 to June 2009, 189 cases, including 19 cases of nasopharyngeal carcinoma, aged 24 to 75 years, were included. The average age was 47.3 years, 15 males and 4 females; There were 16 cases of nasopharyngeal epithelial dysplasia, ranging from 25 to 56 years old, with an average age of 38.9 years (9 males and 7 females) and 47 cases of nasopharyngitis (19 to 62 years old) with an average age of 39.9 years (20 males and 27 females). There were 107 healthy volunteers, aged from 14 to 82 years, with an average age of 38.1 years, 60 males and 47 females. 2% acetic acid solution was applied to the nasopharynx lesion area. The staining of nasopharyngeal mucosa was observed under fibrolaryngoscope 1 minute later, and the images were collected and analyzed. At the same time, the tongue images of some patients were collected and analyzed. Results: different degree of vinegar white reaction appeared in different nasopharynx diseases, and increased according to pathological malignancy. The positive rate of vinegar white reaction in nasopharyngeal carcinoma, nasopharyngeal inflammation with metaplasia was 89.55% and 93.8%, respectively. However, there was no obvious vinegar white reaction in the two groups, and the positive rate of vinegar white reaction was 38.3% 4.7.x2n115.2p0.001, respectively. The normal tongue was more in the healthy control group, accounting for 50% of the total number, while the nasopharyngitis and associated metaplasia were relatively less, while the nasopharyngeal carcinoma group was the least, only 28.5%. The pathological tongue (light tongue and red tongue) in nasopharyngeal carcinoma, nasopharyngitis and associated metaplasia increased, but in the healthy control group relatively decreased. Conclusion: the vinegar white reaction under nasopharynx endoscope has certain diagnostic value for nasopharyngeal epithelial cell carcinogenesis. Vinegar white reaction can be used to guide the preliminary clinical judgement of suspected nasopharynx lesions in order to determine the need for biopsy and to determine the relatively accurate biopsy site. Finally, the accuracy and positive rate of nasopharyngeal carcinoma were improved.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R739.63

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 高體玉,慈云祥,付爽,王德炳;應(yīng)用傅立葉變換紅外光譜研究白血病骨髓血紅細(xì)胞[J];北京大學(xué)學(xué)報(bào)(自然科學(xué)版);2001年02期

2 劉金緒,韓偉,彭英科,馮瑞珍,蘇杏滿(mǎn);關(guān)于癌變細(xì)胞紅外光譜測(cè)定方法的研究[J];分析化學(xué);1998年07期

3 童義平,林燕文,肖育龍,陳森鑫;傅里葉變換紅外光譜對(duì)食道癌及相應(yīng)正常組織的研究[J];分析化學(xué);2002年06期

4 舒焰紅,錢(qián)德英;醋酸試驗(yàn)用于宮頸病變的篩查[J];廣東醫(yī)學(xué);2004年04期

5 曹書(shū)霞,韓華云,鮑改玲;紅外光譜法在癌癥早期診斷中的應(yīng)用[J];光譜實(shí)驗(yàn)室;2003年06期

6 黃紹明,何少健,莫發(fā)榮,梁皓,廖紅,謝小薰,羅國(guó)容;應(yīng)用SEREX技術(shù)篩選與鑒定鼻咽癌相關(guān)抗原[J];廣西醫(yī)科大學(xué)學(xué)報(bào);2005年02期

7 陳孟溪;張紅;蘇志新;毛丹;;鼻咽癌中醫(yī)主癥、證型及常用中藥的文獻(xiàn)研究[J];湖南中醫(yī)藥大學(xué)學(xué)報(bào);2010年01期

8 張金,王東曦,涂滄海,吳廷,陳章洵;福建省福鼎地區(qū)722例鼻咽癌延誤診斷原因分析[J];臨床耳鼻咽喉科雜志;2004年02期

9 龔堅(jiān),鄭億慶,丁健慧,陳秋堅(jiān),李國(guó)照;CT在鼻咽腫物早期診斷中的價(jià)值[J];臨床耳鼻咽喉科雜志;2004年04期

10 楊伶俐;錢(qián)小虎;楊慧琳;;陰道鏡下醋酸白色上皮的病理分析[J];上海醫(yī)學(xué);2007年02期

，

本文編號(hào)：2387509