口咽癌

最后审阅: 3 六月 2022
最后更新: 03 九月 2020

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
更多 关键诊断因素

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)
其他诊断因素

危险因素

  • 存在的危险因素
  • 吸烟
  • 酒精
  • 人类乳头状瘤病毒 (HPV)-16 感染
  • 嚼烟草和槟榔
更多 危险因素

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
更多 首要检查

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)
更多 需考虑的检查

治疗流程

急症处理

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)

持续性治疗

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.

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