Study Of The Correlation Between CT Imaging Of Tumor Spreading To Periphery And Deep Layer Of Nasopharynx And PCNA Expression In Nasopharyngeal Carcinoma

Objectivc:To inveshgate correlation betWeen clinical CT fethees andproliferating cell nuclear antigen (PCNA) in nasophmpgeal carcinoma(NPC), and to judge the malignant degree of NPC, then to overallrecognine the biological characteristic.Mcthods:Nasopharynx talal CT scans were performed in 69 cases of NPCwith biopsy specAnen befOre radiotheraPy, 36 cases of which werefollowed-up for 3 years after radiotheraPy. PCNA exPression wasexamined by means of S-P irnInunohistochemical technique in all cases.The relationship betWeen the CT driaging and prognosis and PCNAexpression was analyzed in details.Result8:(l ) The sequence of CT fmdings in NPC was thickening of the lateralwall of nasopharynX (87.0%), narrowing of paraPhrpgeal space(PPS)(68.l%), thickening and comPactness of the soft-tissue medial tothe styloid process (59.4%), involvement of posterior naris and nasalcavity (42.0%), and bone desmiction of skull base (37.7%).(2) The PCNA positive rate was 94.3%. In 38 cases of thickeningand comPactuess of the soft-tissue medial to the styloid process, 26 caseswere high exPression of PCNA protein (De50%). But in 27 cases ofnormal the softtissue medial to the styloid process, ll cases were highexPression of PCNA protein. So there was a sighflcan differencebetwCen the CT fmdings of the soft-tissue medial tO the styloid proGessand PCNA eXPression (P=0.026). T'he cases of posterior neds and nasalcavity involved had higher rate of PCNA high exPression than that of noone (P=0.04).(3 ) 'fhe disease free survival (DFS) in 3 years after radiotheraPy incases of thickening and cOmPacthess of the soft-tissue mediaI to thestyloid process was lower than that in cases of normal the soft-tissuemedial to the styloid process (P=0.005).Conclusion:(l ) PCNA exPression is high and DFS in 3 years is low in most casesof thickening and compactuess of the soft-tissue medial to the styloidprocess, which suggests that the invasion of the soft4issue mediaI to thestyoid process has higher degree of malignant.(2) PCNA enyession is high in most cases of posterior naris and nasalcavop involved, which is correlative with the strong Proliferative achvityof tUmor and the small resistance of nasal cavity. So the tUInor inVads,1nasal caVity easily(3 ) InVolvement of lhteral wail of nasOPharynx could be seen in mostNPC. After breakthrough the pharyngobasilar fascia. the tUmor usuallyinvades PPS and the soft4issue medial to the styloid Process.