| Objective:Regional nodal metastasis in nasopharyngeal carcinoma plays an important role in the definition of radiotherapy area and clinical staging, it is also one of the main factors influencing prognosis. So this study was designed to explore the pattern of metastatic lymph nodes for patients with nasopharyngeal carcinoma, which may provide a basis of clinical treatment and research.Methods:From Jan.2009to Jul.2011,1298histologically diagnosed nasopharyngeal carcinoma patients had routine MRI scan before radiation therapy at The First Affiliated Hospital of Guangxi Medical University. Diagnostic radiologists and radiation oncologists together assessed the nodal distribution according to the guideline CT-based delineation of lymph node levels. Then, Chi-square test was used to analyze the correlation between T stage and nodal metastasis rate and between nodal diameter and nodal extracapsular invasion.Results:Of1298patients,1067(82.2%) had nodal involvement. The distribution was as follows:20in level â… b,604in level â…¡a,883in level â…¡b, 330in level III,78in level IV,162in level Va,49in level Vb,967in retropharynx. Leap metastasis rate was0.69%. In these patients, a total of2464postive nodes, including1589(64.52%) extra capsular spread nodes, were detected. The rate of nodal extracapsular invasion was higher when the axial diameter increased. No significant correlation was found between T stage and nodal involvement.Conclusions:The level â…¡ and retropharyngeal node were the most frequently involved regions, they had similar metastatic rate and were both the first echo node to metastases of nasopharyngeal carcinoma. Level â… metastasis was very low. The proportion of extracapsular Spread of metastatic lymph nodes increased with axial diameter of lymph nodes-dependent. The cervical node involvement of nasopharyngeal carcinoma was spread orderly down the neck, and the incidence of skip metastasis is rare. There is no significant difference between T stage and nodal involvement. |
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