The Clinical Pathological Study Of Nasopharyngea Carcinoma Cervical Lymph Node Metastasis

Objective: Attempt to study the relationship between the metastasis of nasopharyngeal carcinoma cervical lymph node and the size.Methods:Thirty cases diagnosed with nasopharyngeal carcinoma from November1992to May2011were collected, which were operated by Cervical Lymphadenectomy (whole/partial cervical). The relationship between the metastasis of cervical lymph node and the max-/min-diameter was analysed according to the pathological records of post-operation.Results:1. According to Nasopharyngeal carcinoma pathological type in WHO2003, the number of nonkeratinizing is30.2. There were55lymph nodes in all group, including2nodes in IA region,4nodes in IB region and the rest nodes in Ⅱ～Ⅴ region, without retropharyngeal node. The positive rate of cervical lymph node metastasis were83.6%(46/55) in all group,100%(6/6) in I region and81.6%(40/49) in Ⅱ V region. The diameter was ranged from2mm～45mm(the median was23.75mm) in all group, among them, the positive rate of the diameter<10mm and≥10mm were79.2%(19/24) and87.1%(27/31),respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the minimal axial diameter≥10mm and≥8mm as diagnostic criteria were58.7%、55.6%、58.2%、87.1%、20.8%and69.6%、55.6%、67.3%、88.9%、26.3% respectively. The results of the diameter≥8mm were superior to the group of the diameter≥10mm, but there was no statistical significance(P>0.05).3. There were18cervical lymph nodes in4groups of three or more border-line lymph nodes, the rate of metastasis was83.3%(15/18), among them, the positive rate of the minimal axial diameter≥8mm and <8mm were100%(4/4) and83.3%(15/18), respectively. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the diameter≥8mm and<8mm as diagnostic criteria were26.7%,100%,38.9%,100%,21.4%and26.7%,0%,61.1%,78.6%,0%, respectively, P<0.05.Conclusion:The rate of nasopharyngeal carcinoma cervical lymph node metastasis is higher The clinics must pay more attention to the node of diameter<10mm because of high rate of metastasis. The diameter≥8mm as diagnostic criterias in groups of three or more border-line lymph nodes is reasonable based on a high sensitivity and specificity.