Disease Overview
nasopharyngealcarcinomais发lifeinnasopharyngealregionmucosaupper皮ofmalignant tumor，isChinaSouthern regionscommonofmalignant tumorone of，incidenceRanks first among head and neckcervicalmalignant tumor首position。commonly occurs innasopharyngeal顶anterior壁andpharynxFossa,malesincidenceapproximatelyasfemalesof2-3times，peak age of onset40-50years old。nasopharyngealcarcinomamajorityaspoorly differentiated鳞carcinoma，forradiationtreatmentsensitive，radiotherapyaspreferredtreatmentmethod。due topositionHidden location,early-stagesymptomsnot典type，easyMissed diagnosisorMisdiagnosis,advanced-stagerelatively poor prognosis。
Major Causes
Genetic factors：type族easyfeeltype(South Chinahigh发), Family historygather集type，HLAantigenetc.geneand发diseaserelated。
EBViral infection：EBViral infectionandnasopharyngealcarcinoma发lifeClosely relatedrelated，EBV-DNA阳typecanauxiliaryDiagnosisandmonitorefficacy。
Environmental factors：long-termfoodusingpickledfood(Salted fish,acid菜etc.)，highNickel contentamountenvironmental, Vitamin deficiencylifeelementA、C。
Smoking：andnasopharyngealcarcinomaincidence riskelevatedrelated。
Immunological factors：nasopharyngealcarcinomapatientsnormal伴haveimmunefunctionlowunder。
Occupational factors：long-termExposurein甲aldehyde, Asbestosetc.致carcinoma。
Common Symptoms
noseregionsymptoms：
blood-tinged nasal discharge and epistaxis：using力towardposterior吸nose腔secretiontime，lightthosecancausing涕inBlood-tinged,heavythosecan致nosebleeding。
nasal obstruction：tumorinvasion至posteriornoseNasal opening areacausingMechanicaltypenasal obstruction。
earregionsymptoms：
tinnitus、hearing loss：tumorcompressionpharynxEustachian tubepharynxmouth，appearingclass似secretiontypeinear炎symptoms。
aural fullness：early-stagenon-特differenttypesymptoms。
头regionsymptoms：
headache：unilateralpersistentpain，regionpositionmoreinTemporal, parietalregion，advanced-stageinvasion颅internalmoresignificant。
facial numbness: Trigeminalnervereceive累manifestation。
cervicallymph nodesenlargement：
aslargemajoritypatientsinitialsymptoms，enlargementlymph nodesfirm，noTenderness,early-stagecan活move，advanced-stagenormalfixed。
moreasunilateralcervicallymph nodesenlargement，commonly occurs in颈deepupperlymph nodes。
eyeregionsymptoms：
Visual impairment,visual field defect、diplopia、proptosisand活movereceiveLimitation.
advanced-stageinvasioneye眶or颅nervecausing。
颅nervedamagesymptoms：
No.Ⅴ、Ⅵ、Ⅸ、Ⅹ、Ⅻfor颅nervereceiveInvolvement,causingfacial numbness、diplopia、hoarseness, ExtensiontongueDeviationetc.。
systemicsymptoms：
advanced-stagecanappearingemaciation、anemia、cachexiaetc.。
Pathological Classification
non-keratinizing carcinoma：most common type(accounting for90%and above)，degree of differentiationlow，andEBViral infectionhighdegreerelated
keratinizing squamous cell carcinoma：more见inelderlypatients，EBViral infectionraterelativelylow
basaloid squamous cell carcinoma：high degree of malignancy
glandularcarcinoma：rare，includingglandular泡carcinoma、mucinous adenocarcinomaetc.
othertype: Muscletumor, Malignanttypelymphatictumoretc.
TNM Staging(UICC/AJCC9th edition，2025 update)
Primary Tumor (T)
T1：Tumor confined tonasopharyngeal，orinvasionmouthpharynxand/ornoseCavity,nopharynxParapharyngeal spaceinvasion
T2：Tumor invadespharynxParapharyngeal space,and/orAdjacentsofttissue(Pterygoid muscles, parotidglandularshallow叶)
T3：Tumor invadesskull basebone, Cervical vertebraeorPterygopalatine fossa
T4：Tumor invades颅internalstructure、brainnerve、eyeOrbit, temporalunderFossa,tongueundernerveSpaces
Regional Lymph Nodes (N)
N0：No regional lymph node metastasis
N1：unilateralcervicalor锁boneupperlymph nodesmetastasis，maximum diameter≤6cm，positionin环conditionsoftboneunder缘and above
N2：bilateralcervicalor锁boneupperlymph nodesmetastasis，maximum diameter≤6cm，positionin环conditionsoftboneunder缘and above
N3：lymph nodesmetastasismaximum diameter>6cm，orpositionin环conditionsoftboneunder缘and below(锁boneupper区)，or伴severeCapsuleexternalinvasion
Distant Metastasis (M)
M0：No distant metastasis
M1：Distant metastasis present
M1a：≤3metastasislesion，nohepaticmetastasis
M1b：>3metastasislesion，orhavehepaticmetastasis
Clinical Stage Grouping
Ⅰstage：T1N0M0
Ⅱstage：T2N0M0，T1N1M0，T2N1M0
Ⅲstage：T3N0-2M0，T1-2N2M0
ⅣAstage：T4N0-2M0，anyTN3M0，M1a
ⅣBstage：anyTanyNM1b
Diagnosis
nasopharyngoscopy: IndirectnasopharyngealEndoscope, fiber-opticnasopharyngeal镜orElectronicnasopharyngealEndoscope,foundtumorand取biopsy。
pathologicalDiagnosis：nasopharyngeal镜undermassbiopsyisgold standard，EBVrelatedtesting(EBER原positionmixedCross,plasmaEBV DNA)auxiliaryDiagnosis。
Imaging studies：
nasopharyngealandcervicalplain and contrast-enhanced MRI：assessmentsofttissueinvasion、skull baseboneinvasionandlymph nodesmetastasis
CT：AsMRIcontraindicationEvidence-based replacementplan
PET-CT：usinginsmalllymph nodesmetastasisDetectionandrecurrenceandfibrosisdifferentiate
Tumor markers：plasmaEBV DNAleveland疾diseasestaging、efficacyrelated。
Prevention and Follow-up
avoidfoodusingpickledfoodProducts:reduceSalted fish,acid菜etc.pickledfoodofintake
quit smoking and limit alcohol：reduceincidence risk
allBalanced dietfood：moreintakenewFresh vegetables and fruits, supplement vitaminslifeelementA、C
regularlybodyExamination:high-riskpopulation(South China、havefamily history)regularlyperformedEBVantibodyscreening
follow-up：after treatmentfirst 2 yearsevery 3-4 monthsfollow-up examination，years 3-5every 6 monthsonce，after 5 yearsannuallyonce