Comparative Study Of MRI And Clinical Diagnosis In Nasopharyngeal Carcinoma With Cranial Nerve Invasion And The Correlations With TCM Syndrome

Objective:To explore the incidence rate of MRI diagnosis and clinical diagnosis in nasopharyngeal carcinoma with cranial nerve invasion in newly diagnosed nasopharyngeal carcinoma(NPC) patients respectively,and the coincidence rate between the two ways of diagnosing,and their correlations with the TCM syndrome types.We hope to provide the basis for clinical T staging of NPC and refrence for prevention and treatment of NPC by traditional Chinese medicine(TCM).Methods:Seven hundred and twelve newly diagnosed NPC patients by pathology were enrolled in this study.One hundred and sixty-seven were diagnosed with cranial nerve invasion by MRI or clinical but all of them have one or more nerve invasion in the MRI images.We explore the incidence rate of MRI diagnosis and clinical diagnosis respectively.We analysis the nerve invasion situation of image and clinical, and conclude that the incidence rate of image and clinical diagnosis, and the coincidence rate between them.We also sent them into different TCM syndrome types according to the established standard. Established database of the study and analyze the data by statistics software of SPSS16.0.Results:1.The incidence rate of MRI diagnosis is23.46%(167/712), which is higher than clinical diagnosis(7.30%,52/712).There is significant difference of the incidence rate between the image and clinical diagnosis of nasopharyngeal carcinoma with cranial nerve invasion(P<0.05).The coincidence rate of image and clinical diagnosis in nasopharyngeal carcinoma with cranial nerve invasion is28.14%(47/167)2.In the patients with cranial nerve invasion,there is significant difference of the coincidence rate among the pathogenicheat retention Lung syndrome, the stagnation of liwer-qi and phlegm syndrome, and the blood stasis vessel obstruction syndrome,with2.22%(1/45),6.41%(5/78)、93.18%(41/44) respectively/The blood stasis vessel obstruction syndrome is remarkably higher than the other two types with significant difference(P<0.05).3.There are115patients with cranial nerve invasion by MRI diagnosis but with no clinical symptoms,42is the pathogenicheat retention Lung syndrome,72is the stagnation of liwer-qi and phlegm syndrome, and1is the blood stasis vessel obstruction syndrome.The pathogenicheat retention Lung syndrome is36.52%(42/115),the stagnation of liwer-qi and phlegm syndrome is62.61%(72/115), and the blood stasis vessel obstruction syndrome is0.87%(1/115).There are significant difference among the three syndromes (P<0.05)4.The rest52patients with cranial nerve palsy,3is the pathogenicheat retention Lung syndrome,6is the stagnation of liwer-qi and phlegm syndrome, and43is the blood stasis vessel obstruction syndrome.The pathogenicheat retention Lung syndrome is5.77%(3/52),the stagnation of liwer-qi and phlegm syndrome is11.54%(6/52), and the blood stasis vessel obstruction syndrome is82.69%(43/52).There are significant difference among the three syndromes (P<0.05)Conclusions:l.The incidence of MRI diagnosed nasopharyngeal carcinoma with cranial nerve invasion (23.46%) is higher than clinical diagnosis (7.30%),and their coincidence rate is low (28.14%).2.There is close relationship between the coincidence rate of image and clinical diagnosis and TCM syndrome in newly diagnosed nasopharyngeal carcinoma with cranial nerve invasion,the coincidence rate in the blood stasis vessel obstruction syndrome is remarkably higher than the other two types.There is close relationship between the incidence rate of cranial nerve palsy and TCM syndrome in newly diagnosed nasopharyngeal carcinoma with cranial nerve invasion,the coincidence rate in the blood stasis vessel obstruction syndrome is remarkably higher than the other two types. The blood stasis vessel obstruction syndrome should be highly suspected with cranial nerve palsy clinically.This conclusion can be used as a forward-looking guidance in clinical integrative medicing.3.The process of the nasopharyngeal carcinoma with cranial nerve invasion goes into cranial nerve palsy,which explained in TCM pathogenesis is a development of "the stagnation of liwer-qi and phlegm syndrome"to "the blood stasis vessel obstruction syndrome".The results of macro syndrome differentiation of TCM is in agreement with that the pathological development of western medicine to a certain extent.