Nazofarenks Punch Biyopsi Sonuçlarının Retrospektif Analizi

Abstract

Amaç: Malignite şüphesi nedeniyle yapılan nazofarenks punch biyopsi sonuçlarının değerlendirilmesi.

Materyal ve Metod: Çalışmaya toplam 491 olgu (231 kadın 260 erkek; ortalama yaş 36.72±16.91 yıl, aralık 16-90 yıl) dahil edildi. Tüm olguların dosyaları, yaş, cinsiyet, biyopsi yapılma nedeni ve biyopsi sonuçları açısından retrospektif olarak değerlendirildi.

Bulgular: Malignite şüphesi olan ve ayırıcı tanı amacıyla nazofarenks punch biyopsisi yapılan hastalardan 21’i (%4.2) nazofarenks karsinomu tanısı almıştır. Diğer olguların patolojik değerlendirme sonuçları; 454 benign patoloji (lenfoid hiperplazi, kronik lenfoid süreç, (Tornwald kisti) (%92.46), 12 yetersiz materyal (%2.44) ve 4 granülamatöz hastalık (%0.8) olarak saptanmıştır. Malignite saptanan olguların ortalama yaşları, patoloji sonucu benign olan olgulara göre istatistiksel olarak anlamlı düzeyde daha yüksektir (p=0.000). Malign ve benign olguların cinsiyet dağılımında istatistiksel olarak anlamlı farklılık saptanmamıştır.  

Sonuç: Nazofarenks kanseri şüphesinde, endoskopik muayenede yer kaplayıcı kitle olmasa da mukoza ve submukozayı içeren punch biyopsi uygulaması nazofarenks kanserinin erken tanı ve tedavisine imkan sağlayacaktır.

Keywords

• nazofarenks; biyopsi; endoskopi; kanser; punch

Retrospective Analysis of Nasopharynx Punch Biopsy Results

Abstract

Aim: Evaluation of nasopharyngeal punch biopsy results due to malignancy suspicion.

Material and Method: In total, 491 patients (231 females 260 males; average age 36.72± 16.91 years; range 16 –90 years) were included in the present study. All patients files were evaluated in terms of age, gender, the reason and the results of biopsy.

Results: Nasopharyngeal carcinoma was diagnosed in 21 patients (4.2%) as a result of nasopharyngeal punch biopsies performed due to malignancy suspicion and exclusion. Results of pathological evaluation of other patients; 454 benign pathologies (lymphoid hyperplasia, chronic lymphoid process, Tornwald cyst) (92.05%), 12 insufficient material (2.44%) and 4 granulomatous diseases (0.8%), respectively. The mean age of patients with malignancy was statistically significantly higher than those with benign pathology (p = 0.000). There was no statistically significant difference in the gender distribution of malignant and benign cases (p = 0.077).

Conclusion: Taking punch biopsies containing mucosa and submucosa will provide the early diagnosis and treatment of nasopharyngeal carcinoma, in spite of the absence of a mass on endoscopic examination.

Keywords

• nasopharynx,biopsy,endoscopy,cancer

References

1. 1- Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127(12):2893-917.
2. 2- Ho KY, Lee KW, Chai CY, Kuo WR, Wang HM, Chien CY. Early recognition of nasopharyngeal cancer in adults with only otitis media with effusion. J Otolaryngol Head Neck Surg 2008; 37: 362-5.
3. 3- Wei WI, Sham JST. Nasopharyngeal carcinoma. Lancet 2005; 365: 2041-54.
4. 4- Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61: 69-90.
5. 5- Chang ET, Adami HO. The enigmatic epidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev 2006; 15: 1765-77.
6. 6- August M, Dodson TB, Nastri A, Chuang SK. Nasopharyngeal carcinoma: clinical assessment and review of 176 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91: 205-14.
7. 7- Huang WB, Chan JYW, Liu DL. Human papillomavirus and World Health Organization type III nasopharyngeal carcinoma: Multicenter study from an endemic area in Southern China. Cancer 2017 Oct 26. doi: 10.1002/cncr.31031. [Epub ahead of print]
8. 8- Grammatica L, Achille G, Piepoli S, Paradiso A. Early, late symptoms and histological type of nasopharyngeal carcinoma. Oncol Rep 2005;6:1395-8.

9. 9- Tutar B, Berkiten G, Kumral TL,Yıldırım G, Uyar Y, Kamalı GH. Punch Biyopsy Results of Nasopharynx Pathologies: 3 Years Retrospective Analysis. Okmeydani Tip Derg 2014; 30(1): 30-3.
10. 10- Douglas SA, Nelson N, Ashman H. Clinical features of nasopharyngeal carcinoma in Jamaica. Journal of the National Medical Assosication 2003;95:77-81.
11. 11- Başak S, Metin K, Erpek G, Nar H. Erişkin yaş grubunda görülen sekretuar otitis mediada nazal kavite ve nazofarenks patolojileri. KBB ve Baş Boyun Cerrahisi Dergisi 1999;7:1-5.
12. 12- Glynn F, Keogh IJ, Ali TA, Timon CI, Donnelly M. Routine nasopharyngeal biopsy in adults presenting with isolated serous otitis media: is it justified. The Journal of Laryngology and Otology 2006;120:439-41.
13. 13- Pfister DG, Ang KK, Brizel DM, Burtness BA, Busse PM, Caudell JJ, et al. Head and neck cancers, version 2.2013. Featured updates to the NCCN guidelines. J Natl Compr Canc Netw 2013; 11: 917-23.
14. 14- Dang PT, Gubbels SP. Is nasopharyngoscopy necessary in adult-onset otitis media with effusion? Laryngoscope 2013; 123: 2081-2.
15. 15- King AD, Vlantis AC, Bhatia KSS, Zee BC, Woo JK, Tse GM, et al. Primary nasopharyngeal carcinoma: diagnostic accuracy of MR imaging versus that of endoscopy and endoscopic biopsy. Radiology 2011; 258: 531-7.
16. 16- Bercin S, Yalciner G, Muderris T, Gul F, Deger HM, Kiris M. Pathologic Evaluation of Routine Nasopharynx Punch Biopsy in the Adult Population: Is It Really Necessary?. Clin Exp Otorhinolaryngol 2017;10(3):283-7.
17. 17- Özbay İ, Kucur C, Aksoy S, Oğhan F, Külekçi S, Yıldırım N. Nazofarenks Patolojilerinde Punch Biyopsi Sonuçları. J Clin Exp Invest 2016; 7 (1): 83-6.
18. 18- Abu-Ghanem S, Carmel NN, Horowitz G, Yehuda M, Leshno M, Abu-Ghanem Y, et al. Nasopharyngeal biopsy in adults: a large-scale study in a non endemic area. Rhinology 2015;53(2):142-8.