小结
定义
病史和体格检查
关键诊断因素
- 口腔疼痛
- 体重减轻
其他诊断因素
- 咽痛
- 颈部包块
- 质硬或溃疡包块
- 吞咽困难
- 颈部淋巴结肿大
- 耳痛
- 张口困难
- 白斑（黏膜白斑病）及红斑（黏膜红斑病）
危险因素
- 存在的危险因素
- 吸食烟草香烟
- 酒精
- 人类乳头状瘤病毒 (HPV)-16 感染
- 嚼烟草和槟榔
诊断性检查
首要检查
- 原发部位活检
- 头颈部PET-CT
- 颈淋巴结细针穿刺细胞学 (FNAC)
- 颈部淋巴结切除活检
需考虑的检查
- 头颈部CT扫描
- 头颈部MRI
- 上消化道内镜检查或三联内镜
- 改良吞钡造影检查
- HPV-16原位杂交，p16免疫组化，或活检标本PCR
- 全血细胞计数 (FBC）
- 电解质
- 血浆尿素/氮
- 血清肌酐
- 总蛋白
- 白蛋白
- 前白蛋白
- 肝功能检查 (LFT)
治疗流程
I期或II期（早期病变）
III期及IVA期（局部晚期且可手术切除）
IVB期（局部晚期且不可手术切除）
IVC期（远处转移）
复发性疾病
撰稿人
作者
Nam P. Nguyen, MD
Professor and Chair
Radiation Oncology Department
Howard University
Washington
DC
利益声明
NPN is an author of a number of references cited in this topic.
Fabio Almeida, MD
Assistant Professor of Radiology
University of Arizona
Tucson
AZ
利益声明
FA declares that he has no competing interests.
鸣谢
Dr Nam P. Nguyen and Dr Fabio Almeida would like to gratefully acknowledge Dr Linda Garland, a previous contributor to this topic.
利益声明
LG is on the speakers' bureau for Sanofi-Aventis, maker of Taxotere.
同行评议者
AJ Balm, MD, PhD, FACS, FRCS
Chair Emeritus
Head and Neck Multidisciplinary Cooperative Group
Department of Head & Neck Oncology and Surgery
The Netherlands Cancer Institute
Amsterdam
The Netherlands
利益声明
AJB declares that he has no competing interests.
Andy Trotti, MD
Specializing in Head & Neck Cancer
Director of Clinical Trials
Radiation Oncology
H. Lee Moffitt Cancer Center & Research Institute
Tampa
FL
利益声明
AT is an author of a reference cited in this topic.
Hari Deshpande, MD
Assistant Professor of Medicine
Yale Cancer Center
Yale University
New Haven
CT
利益声明
HD is on the speakers' bureau for Sanofi-Aventis and has received reimbursement for talks given about their product Taxotere.
鉴别诊断
- 扁桃体炎
- 阿弗他溃疡
- 口腔梅毒
更多 鉴别诊断指南
- NCCN肿瘤临床实践指南：头颈癌
- 铂类化疗后使用纳武利尤单抗治疗复发性或转移性头颈部鳞状细胞癌
更多 指南患者教育信息
咽痛
戒烟
更多 患者教育信息
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