Comparision Of Chinese 08 Chinese Stage, 92 Staging And 02UICC/AJCC Staging In T Staging Of Nasopharyngeal Carcinoma

Objective To investigate the different influences of Chinese 08 staging system , 92 staging system and 02 International Union Against Cancer/American Joint Committee on Cancer (UICC/AJCC) staging system on T staging, by analyzing the computerized tomography (CT) and magnetic resonance imaging (MRI) datum of 104 nasopharyngeal carcinoma (NPC) sufferers. Methods From Jan to Jun 2009 , One hundred and four cases,pathologically proved as nasopharyngeal carcinoma, were selected, and all of them were received both enhanced CT and MRI scan of the nasopharynx and cervix one week before treatment. CT scan was performed by CT (GE Lightspeed Ultra 8 ) scans , supine. Enhancement scans were carried out from articulationes sternoclavicularis to suprasellar cistern, 5 mm thick for each layer , part of which were splited to 2.5 mm , then the results were sent to GE AW 4.2 workstation to multiplannar reformation ( incline/sagittal/ coronal /curved plannar ). MRI scan was performed by GE Signa 1.5 T super-conducting magnetic resonance imaging. The standard quadrature head coil was used, 6 mm thick and 1mm distance for each layer. Six sequence: Axial T1 FSE , Sagital T1 FSE , Axial FSE T2fs , Axial T1 FSEfs + Gd , Coronal STIR , Axial T1 FSEfs + Gd and Coronal T1 FSEfs + Gd were conclude, and more than two of them must be carried out from middle temporal lobe to throat of thorax. Coronal is in parallel with the third cervical vertebrae and axial is vertical to the third cervical vertebrae, which buildup the scan plane.Further more, the CT imaging datum was compared with MRI imaging datum (especially in the base of skull invasion). All of datum were analyzed by statistical software spss 13.0 .Results In the 104 NPC cases , MRI was better than CT in detecting the invasion of NPC base of skull,such as clivus, sphenoid body, lateral pterygoid plate, petrous apex bone and cavernous sinus , MRI detecting skull invasion 65 cases (62.5 %) , but CT detecting skull invasion 30 cases (28.8% ) . There were statistical differences between them (p<0.05 ,χ~2=23.735 ).In the 104 NPC cases , for the Chinese 08 staging and 92 staging system , there were statistical differences in T2,T3 stage and population distribution(p<0.05 ,χ~2=11.493 ).In the 104 NPC cases , according to the Chinese 08 staging system and the 02 UICC/AJCC staging system, there were statistical differences in T2,T3,T4 stage and population distribution(p<0.05 ,χ2=15.887 ).Conclusion Based on MRI, the '08 staging system is later than '92 Fuzhou staging system stage and '02UICC / AJCC staging system for NPC T-stage. Their differences in T staging would have an important impact on the decision making and prognosis of NPC treatment programs. In view of the new staging system is more suited to the new technological developments in the diagnosis and treatment, it should have a higher clinical value than the old staging system. In addition, prospective study and long-term follow-up of multi-center and major cases are needed in order to confirm its long-term effects.