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目的:探讨基于MR图像的原发肿瘤体积测量与我国鼻咽癌2008分期中T、N和临床分期的相关性。方法:回顾性分析2011年9月—2015年12月经病理证实的113例鼻咽癌患者的影像学及临床资料。依据我国鼻咽癌2008分期标准判断鼻咽癌患者的T、N和临床分期。基于横断位T2加权压脂像,逐层手动勾画肿瘤边界,采用面积求和法计算肿瘤体积。结果:原发肿瘤体积随T分期进展逐渐增大(P<0.01)。相邻T分期间两两比较,T1/T2、T3/T4期间原发肿瘤体积差异有统计学意义(P<0.05),T2/T3期间差异无统计学意义(P>0.05)。全组颈部淋巴结转移率为83.19%。N0~N3期原发肿瘤体积差异无统计学意义(P>0.05)。临床Ⅰ~Ⅳ期原发肿瘤体积差异有统计学意义(P<0.01)。相邻临床分期间两两比较,Ⅰ与Ⅱ、Ⅱ与Ⅲ期间差异无统计学意义(P>0.05),Ⅲ与Ⅳ期间差异有统计学意义(P<0.01)。结论:鼻咽癌原发肿瘤体积与我国2008分期中T和临床分期密切相关,可考虑将鼻咽癌原发肿瘤体积纳入后续分期,以帮助判断疾病预后。
OBJECTIVE: To investigate the correlation between primary tumor volume measurement based on MR images and T, N and clinical stage of nasopharyngeal carcinoma in 2008 in China. Methods: The imaging and clinical data of 113 nasopharyngeal carcinoma patients confirmed by pathology from September 2011 to December 2015 were analyzed retrospectively. To judge the T, N and clinical stages of NPC patients according to the 2008 staging criteria of nasopharyngeal carcinoma in China. On the basis of transverse T2 weighted fat-pressed image, the tumor boundary was manually sketched by layer, and the tumor volume was calculated by the area summation method. Results: The primary tumor volume gradually increased with T stage (P <0.01). There were significant differences in the volume of primary tumor between T1 / T2 and T3 / T4 (P <0.05), but no significant difference between T2 and T3 (P> 0.05). The whole group of cervical lymph node metastasis rate was 83.19%. N0 ~ N3 primary tumor volume difference was not statistically significant (P> 0.05). There was significant difference in the volume of primary tumors in stage Ⅰ-Ⅳ (P <0.01). There was no significant difference between Ⅰ and Ⅱ, Ⅱ and Ⅲ in adjacent clinical stages (P> 0.05), while the difference between Ⅲ and Ⅳ was statistically significant (P <0.01). Conclusions: The volume of primary tumor of nasopharyngeal carcinoma is closely related to the T stage and clinical stage in our country in 2008. The primary tumor volume of nasopharyngeal carcinoma can be considered in the follow-up stage to help determine the prognosis of the disease.