【摘要】 目的分析鼻-鼻窦良、恶性肿瘤的临床特征,以提高其临床诊断准确性。方法对经病理证实的258例鼻-鼻窦肿瘤患者的临床资料进行回顾性分析并对比良、恶性肿瘤的临床差异。结果鼻-鼻窦肿瘤临床症状表现多样。鼻出血或涕中带血、头痛、面部麻木或疼痛、眼痛或溢泪所占比率比较,恶性肿瘤患者明显高于良性肿瘤患者(P<0.05);行手术治疗的196例患者中,良、恶性肿瘤术前石蜡病检与术后石蜡病检符合率相比,差异无统计学意义(P>0.05)。行手术治疗的63例恶性肿瘤中,共行232个切缘冰冻病检,与术后石蜡冰冻病检符合率为98.70%(229/232)。34例术中冰冻与术后石蜡病检符合率为91.18%(31/34),其中行术中即时冰冻6例,66.67%(4/6)的患者与术前石蜡活检诊断不相符,从良性变为恶性。结论鼻-鼻窦肿瘤临床表现缺乏特异性,术中快速冰冻病检有利于提高诊断率;恶性肿瘤的切缘应行连续冰冻病检。更多还原

【Abstract】 Objective To analyze the clinical features of 258 cases of nasal-sinus benign and malignant tumors to improve the accuracy of clinical diagnosis.Methods The clinical data of 258 patients with nasal-sinus tumor confirmed by pathology were retrospectively analyzed and the clinic differences between benign and malignant tumors were compared.Results The clinic manifestations of sinonasal neoplasm were varied.The incidences of epistaxis or blood in the tears,headache,facial numbness or pain,eye pain or epiphora were significantly higher in the benign tumors group than in the malignant tumors group(P<0.05).Among196 patients undergoing surgery,the coincidence rates of preoperative and postoperative paraffin sections were similar in the two groups(P>0.05).Among 63 surgical patients with malignant tumors,the coincidence rate of 232 incised-margin frozen sections and postoperative paraffin sections was 98.70%(229/232).Among 34 cases,the coincidence rate of frozen sections and postoperative paraffin sections was 91.18%(31/34),in which 6 cases were immediately intraoperative frozen,and 66.67%(4/6)of the cases that changed into malignancy from benignity were not consistent with the preoperative diagnosis of paraffin sections.Conclusion The sinonasal tumors are lacking specificity in clinical manifestations,but rapid intraoperative frozen section examination is helpful to improve the diagnosis rate;continuously frozen pathological examination should be performed in malignant tumor margins.更多还原