介入超声辅助诊断鼻咽癌肝脏转移1例

A Case of Liver Metastasis of Nasopharyngeal Carcinoma Diagnosed with the Aid of Interventional Ultrasound

摘要: 鼻咽癌(NPC)是一种常见的头颈部恶性肿瘤，在东南亚地区发病率较高。最常见的转移部位是肺、骨、肝和淋巴结。通常鼻咽癌肝转移预后较差。鼻咽癌肝转移常表现为多灶性结节。早期鼻咽癌肝转移，在超声图像上表现为囊性结节；进展期图像常以实性、富血供为主。目前转移性鼻咽癌的治疗基本上是姑息性的；转移性鼻咽癌的治疗选择包括临床试验(首选)、铂基联合化疗或同步化疗、放疗；围手术期行肝动脉灌注泵化疗联合肝脏转移瘤切除术，可提高患者术后生存期。现有的新治疗方法中，免疫检查点疗法在治疗复发或转移性疾病方面取得了突破性进展，为鼻咽癌的治疗提供了广阔的前景。

Abstract: Nasopharyngeal carcinoma (NPC) is a common malignant tumor of the head and neck, with a high incidence in Southeast Asia. The most common sites of metastasis are lung, bone, liver and lymph nodes. Usually, the prognosis of liver metastasis from NPC is poor. Liver metastases from nasopharyngeal carcinoma often present as multifocal nodules. In the early stage of nasopharyngeal carcinoma liver metastasis, it appears as cystic nodules on ultrasound images; in the progressive stage, the images are often solid and rich in blood supply. Current treatment for metastatic nasopharyngeal carcinoma is essentially palliative; treatment options for metastatic nasopharyngeal carcinoma include clinical trials (preferred), platinum-based combination chemotherapy or concurrent chemotherapy and radiotherapy. Perioperative hepatic artery perfusion pump chemotherapy combined with liver metastasectomy may improve patient survival after surgery. Among the available new therapeutic approaches, immune checkpoint therapy has made breakthroughs in the treatment of recurrent or metastatic disease, offering a promising future for the treatment of nasopharyngeal carcinoma.