Nasopharyngeal carcinoma is a frequent malignant tumor in the southern region of China (the incidence rate of people whose ancestral origin is south of Yangtze River is significantly higher than that in the northern region). The lesion is deep in the central part of the skull, and the clinical manifestations are extremely complex and variable. It is very important to take detailed medical history, including family history of nasopharyngeal cancer. If a patient has unexplained persistent or intermittent retractable nasal blood (or sputum blood, especially blood in sputum in the early morning), unilateral nasal congestion, tinnitus, ear occlusion, hearing loss, headache, diplopia or neck mass, indirect nasopharyngoscopy or electronic endoscopy should be performed as early as possible, and nasopharyngeal biopsy should be performed as appropriate or at an optional date according to the results. The necessary tests such as EBV serology (VCA-IgA, IgM, IgG), serum ferritin, serum squamous carcinoma antigen, carcinoembryonic antigen, enhanced CT of nasopharynx and skull base can also be performed.
How to detect and diagnose nasopharyngeal cancer at an early stage?
1.We should pay attention to the differential diagnosis of the first or initial symptoms. According to clinical survey, the most common first symptoms of nasopharyngeal cancer (in order of frequency) are: neck mass (unilateral), nasal bleeding (manifested as retracted snot and blood, blood in snot or sputum), headache, tinnitus, nasal congestion, hearing loss, diplopia (double vision), hoarseness, distant metastasis (e.g. lung metastasis may appear cough, cough blood, chest pain, etc.; bone metastasis may appear pain in the corresponding area), and dermatomyositis. The symptoms may include coughing, coughing blood, chest pain, etc.; bone metastases may have pain at the corresponding site), and dermatomyositis. Only one of the above symptoms may appear, or one symptom may appear first, then several symptoms may appear, or several symptoms may appear at the same time. If the symptoms are intermittent or persistent for more than 2 weeks, we should be alert to the possibility of nasopharyngeal cancer after excluding inflammatory and bleeding diseases.
2. To understand the special features of nasopharyngeal cancer diagnosis. Due to the special anatomical structure of nasopharynx and its adjacent important tissues, the diagnosis of nasopharyngeal cancer is significantly different from that of malignant tumors in any other parts of the body. Therefore, a comprehensive assessment should be made for suspected patients, and special attention should be paid to close follow-up, and repeated nasopharyngeal biopsies should be performed several times if necessary until the diagnosis is confirmed.