上咽頭悪性腫瘍の病理組織分類と放射線感受性

Histopathology and Radiosensitivity of Nasopharyngeal Carcinoma

I．はじめに

　上咽頭悪性腫瘍は初診時進展した症例が多く，解剖学的特徴から手術が困難でかつ放射線感受性の高い腫瘍が大部分を占めていることもあり，放射線治療が主として行われている。放射線感受性は組織型により異なるとされてきたが，病理組織分類は血清抗VCA抗体価などの血清疫学，治療効果も相まって統一的見解に欠けていた。本報告は1978年WHO分類に基づき上咽頭悪性腫瘍を再分類し，各組織の放射線治療効果，予後と臨床経過の相関関係を検討することを目的とした。

　A total of 47 cases of nasopharyngeal carcinoma, treated with radiation from 1973 to 1980, was clinically analyzed by using the WHO classification (1978). Possible relations of the histologic types to clinical courses and responses to radiotherapy were investigated in terms of survival rates, local control and distant metastases.

　The 5-year survival was 42%, 33%, and 15% for those with lymphoepithelioma, nonkeratinizing carcinoma, and undifferentiated carcinoma respectively. Lymphoepithelioma showed a better local control and had a greater likelihood of distant metastases than undifferentiated carcinoma. Our findings would support the view that lymphoepithelioma is regarded as a separate histologic entity.