Cov qog nqaij hlav hauv nasopharyngeal pib tom qab ntawm qhov ntswg, los ntawm ib feem saum lub palate mus rau sab sauv ntawm caj pas. Cov neeg uas muaj tus kab mob no feem ntau tsim cov nodules nyob rau hauv lub caj dab, tej zaum yuav hnov ​​​​qhov puv lossis mob hauv pob ntseg, thiab tsis hnov ​​​​lus. Cov tsos mob tom qab muaj xws li qhov ntswg qhov ntswg, qhov ntswg qhov ntswg, o ntawm lub ntsej muag thiab loog loog. Kev kuaj ntshav biopsy yuav tsum tau ua kom kuaj pom thiab kuaj pom (CT, MRI, lossis PET) ua tiav los ntsuas qhov mob qog noj ntshav. Kev kho mob yog ua raws li kev kho mob hluav taws xob thiab tshuaj khomob thiab, tshwj xeeb, ntawm kev phais.

Nasopharyngeal cancer, tseem hu ua nasopharynx, cavum lossis epipharynx, yog mob qog noj ntshav ntawm epithelial keeb kwm, uas tsim nyob rau hauv cov hlwb ntawm sab sauv ntawm lub pharynx, tom qab qhov ntswg qhov ntswg, los ntawm sab saum toj ntawm lub palate mus rau sab sauv. caj pas. Feem ntau cov qog nqaij hlav ntawm nasopharynx yog squamous cell carcinomas, uas txhais tau hais tias lawv tsim nyob rau hauv squamous hlwb nyob rau hauv lub nasopharynx.

Txawm hais tias mob qog noj ntshav nasopharyngeal tuaj yeem tshwm sim rau txhua lub hnub nyoog, tshwj xeeb tshaj yog cuam tshuam rau cov tub ntxhais hluas thiab cov neeg mob hnub nyoog 50 xyoo. Txawm hais tias tsis tshua muaj nyob hauv Tebchaws Meskas thiab Europe sab hnub poob, nws muaj nyob rau hauv Asia thiab yog ib qho kabmob kheesxaws feem ntau ntawm cov neeg tsiv teb tsaws chaw Suav mus rau Tebchaws Meskas. Cov xeev, tshwj xeeb tshaj yog cov neeg South Suav thiab yav qab teb qhovntsej thiaj tsis mob. - Neeg Esxias. Mob qog noj ntshav Nasopharyngeal tsis tshua muaj nyob hauv Fabkis nrog tsawg dua ib kis ntawm 100 tus neeg nyob hauv. Cov txiv neej feem ntau cuam tshuam ntau dua li poj niam.

Nasopharyngeal epithelial qog tau raug cais los ntawm Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb raws li qib ntawm kev sib txawv ntawm cov kab mob malignant:

• Hom I: txawv keratinizing squamous cell carcinoma. Tsis tshua muaj, nws yog pom tshwj xeeb tshaj yog nyob rau hauv cov cheeb tsam ntawm lub ntiaj teb no uas muaj tsawg heev tshwm sim;
• Hom II: sib txawv uas tsis yog-keratinizing squamous cell carcinoma (35 mus rau 40% ntawm cov neeg mob);
• Hom III: Undifferenciated Carcinoma of Nasopharyngeal Type (UCNT: Undifferenciated Carcinoma of Nasopharyngeal Type). Nws sawv cev rau 50% ntawm cov neeg mob hauv Fabkis, thiab nruab nrab ntawm 65% (North America) thiab 95% (Tuam Tshoj) ntawm cov neeg mob;
• Lymphomas uas sawv cev kwv yees li 10 mus rau 15% ntawm cov neeg mob.

Lwm cov qog nqaij hlav nasopharyngeal muaj xws li:

• adenoid cystic carcinomas (cylindromes);
• cov qog nqaij hlav sib xyaw;
• adenocarcinomas;
• fibrosarcomas;
• osteosarcomas;
• chondrosarcomas;
• melanomas.
  

Ntau yam kev coj noj coj ua thiab ib puag ncig tau pom tias yog carcinogenic rau tib neeg hauv kev sib txuas nrog mob qog noj ntshav nasopharyngeal:

• Tus kab mob Epstein-Barr: tus kab mob no los ntawm tsev neeg herpes kis cov lymphocytes ntawm lub cev tiv thaiv kab mob thiab qee lub hlwb nyob rau hauv ob sab phlu ntawm lub qhov ncauj thiab pharynx. Kev kis kab mob feem ntau tshwm sim thaum yau thiab tuaj yeem tshwm sim raws li kab mob ua pa los yog kis kab mob mononucleosis, kab mob me me ntawm cov menyuam yaus thiab cov hluas. Ntau tshaj 90% ntawm cov neeg thoob ntiaj teb tau kis tus kab mob no, tab sis feem ntau nws tsis muaj mob. Qhov no yog vim tsis yog txhua tus neeg uas muaj tus kab mob Epstein-Barr tsim mob qog noj ntshav nasopharyngeal;
• Kev noj ntau ntawm cov ntses khaws cia lossis npaj hauv ntsev, lossis cov zaub mov khaws cia los ntawm nitrites: txoj kev khaws cia lossis kev npaj no tau ua nyob rau ntau thaj tsam ntawm lub ntiaj teb, thiab tshwj xeeb hauv South-East Asia. Txawm li cas los xij, cov txheej txheem txuas cov khoom noj no rau kev tsim cov qog nqaij hlav nasopharyngeal tseem tsis tau tsim kom meej meej. Ob qhov kev xav tau muab tso rau pem hauv ntej: kev tsim ntawm nitrosamines thiab rov ua kom tus kab mob Epstein-Barr;
• Kev haus luam yeeb: qhov kev pheej hmoo nce ntxiv nrog rau qhov ntau thiab ntev ntawm kev haus luam yeeb;
• formaldehyde: cais nyob rau hauv 2004 ntawm cov carcinogenic tshuaj pov thawj nyob rau hauv tib neeg rau mob cancer ntawm nasopharynx. Kev cuam tshuam rau formaldehyde tshwm sim hauv ntau tshaj li ib puas qhov chaw ua haujlwm thiab ntau yam kev ua haujlwm: kws kho tsiaj, tshuaj pleev ib ce, tshuaj, kev lag luam, kev ua liaj ua teb, thiab lwm yam.
• ntoo plua plav: emissions thaum lub sij hawm ua hauj lwm ntoo (poob, sawing, sib tsoo), machining ntawm cov ntoo ntxhib los yog reconstituted ntoo panels, thauj cov chips thiab sawdust uas tshwm sim los ntawm cov transformation, xov ntawm rooj tog (ginning). Cov plua plav ntoo no tuaj yeem nqus tau, tshwj xeeb tshaj yog los ntawm cov neeg uas raug mob thaum lawv ua haujlwm.

Lwm yam kev pheej hmoo rau mob qog noj ntshav nasopharyngeal yog xav tias nyob rau hauv lub xeev tam sim no ntawm kev paub:

• tsis haus luam yeeb;
• Kev haus cawv;
• noj nqaij liab lossis ua tiav;
• kab mob papillomavirus (HPV 16).

Ib qho kev pheej hmoo ntawm caj ces kuj tau txheeb xyuas los ntawm qee qhov kev tshawb fawb.

Feem ntau, mob qog noj ntshav nasopharyngeal thawj zaug kis mus rau cov qog nqaij hlav, ua rau palpable nodules hauv caj dab, ua ntej lwm yam tsos mob. Qee zaum kev cuam tshuam tsis tu ncua ntawm lub qhov ntswg lossis eustachian hlab tuaj yeem ua rau muaj kev zoo siab lossis mob hauv pob ntseg, nrog rau kev hnov ​​​​lus tsis zoo, ntawm ib sab. Yog tias lub raj eustachian raug thaiv, cov kua dej tuaj yeem tsim nyob rau hauv nruab nrab pob ntseg.

Cov neeg muaj tus kab mob no kuj yuav muaj:

• ntsej muag o;
• lub qhov ntswg ua kua paug thiab ntshav;
• epistaxis, uas yog, nosebleeds;
• ntshav hauv qaub ncaug;
• ib feem tuag tes tuag taw ntawm lub ntsej muag lossis qhov muag;
• lymphadenopathy ntawm ncauj tsev menyuam.

Txhawm rau kuaj mob qog noj ntshav hauv nasopharyngeal, tus kws kho mob thawj zaug tshuaj xyuas lub nasopharynx nrog daim iav tshwj xeeb lossis ib lub raj nyias nyias, hu ua endoscope. Yog tias pom qog nqaij hlav, tus kws kho mob tau kuaj pom tus nasopharyngeal biopsy ua tiav, uas yog coj mus kuaj cov ntaub so ntswg thiab kuaj hauv lub tshuab ntsuas.

Kev soj ntsuam tomography (CT) ntawm lub pob txha taub hau thiab magnetic resonance imaging (MRI) ntawm lub taub hau, nasopharynx, thiab lub hauv paus pob txha taub hau yog ua los ntsuas seb qhov mob qog noj ntshav. Ib qho positron emission tomography (PET) scan feem ntau yog ua los ntsuas seb qhov mob qog noj ntshav thiab qog nqaij hlav hauv caj dab.

Kev kho mob thaum ntxov zoo txhim kho qhov kev mob tshwm sim rau mob qog noj ntshav nasopharyngeal. Kwv yees li 60-75% ntawm cov neeg mob qog noj ntshav thaum ntxov muaj qhov tshwm sim zoo thiab muaj sia nyob tsawg kawg 5 xyoos tom qab kuaj mob.

Raws li nrog tag nrho cov qog nqaij hlav ENT, lwm txoj kev sib txawv thiab cov tswv yim kho mob tau tham txog hauv CPR txhawm rau muab tus neeg mob txoj kev kho tus kheej. Lub rooj sib tham no yog ua los ntawm ntau tus kws kho mob koom nrog hauv kev saib xyuas tus neeg mob:

• kws phais mob;
• radiotherapeute;
• oncologist;
• kws kho mob radiologist;
• kws kho mob hlwb;
• anatomopathologist;
• kws kho hniav

Vim lawv qhov chaw nyob thiab thaj chaw txuas ntxiv, cov qog nqaij hlav nasopharyngeal tsis tuaj yeem siv rau kev kho mob phais. Lawv feem ntau yog kho nrog kws khomob thiab xov tooj cua, uas feem ntau ua raws li kev siv tshuaj khomob ntxiv:

• chemotherapy: dav siv, vim hais tias mob qog noj ntshav nasopharyngeal yog chemosensitive qog. Cov tshuaj siv dav tshaj plaws yog bleomycin, epirubicin thiab cisplatin. Tshuaj kho mob yog siv ib leeg los yog ua ke nrog kev siv xov tooj cua (concomitant radiochemotherapy);
• sab nraud kab hluav taws xob kho mob: kho cov qog thiab qog nqaij hlav;
• conformational radiotherapy nrog kev siv zog hloov kho (RCMI): tso cai rau kev txhim kho hauv cov qog dosimetric npog nrog zoo dua sparing ntawm cov qauv noj qab haus huv thiab thaj chaw muaj kev pheej hmoo. Qhov nce hauv salivary toxicity yog qhov tseem ceeb piv rau cov pa irradiation thiab lub neej zoo tuaj nyob rau lub sij hawm ntev;
• brachytherapy lossis kev tso chaw ntawm cov khoom siv hluav taws xob: tuaj yeem siv tau los ua ib qho ntxiv tom qab irradiation sab nraud ntawm cov koob tshuaj tag nrho lossis raws li kev ntes thaum muaj qhov tshwm sim me me.

Yog tias cov qog rov tshwm sim, kev kho hluav taws xob tau rov ua dua lossis, nyob rau hauv cov xwm txheej tshwj xeeb, kev phais yuav raug sim. Qhov no txawm li cas los xij nyuaj vim nws feem ntau cuam tshuam nrog kev tshem tawm ib feem ntawm lub hauv paus ntawm pob txha taub hau. Nws yog qee zaum ua los ntawm lub qhov ntswg siv qhov endoscope.