Особенности первичной диагностики и алгоритм дальнейшей маршрутизации пациентов с новообразованиями орофарингеальной области на стоматологическом приеме
- № 2 2021
Страницы:
19
–
26
Язык: русский
Аннотация
Онкологические процессы головы и шеи это большое количество опухолей имеющих различное течение и требующих разного лечения. В запущенных стадиях это лечение может приводить к потере жизненно важных функции и нарушать внешний облик человека с появлением костных и мягко-тканных дефектов [3]. Но если этот процесс
выявляется в самом начале при бессимптомном течении или же на I стадии заболевания, то в 95-97% случаев может быть произведено удаление новообразования без инвалидизации [5]. На данном этапе развития современной медицины, при помощи лучевой терапии и эндоскопической хирургии, возможно эффективно лечить онкологические процессы головы и шей на I и II стадиях заболеваний [2, 6]. Применительно к использованию эндоскопической хирургии снижается риск развития
психологической травмы больных, за счет отсутствия больших разрезов [8]. В данной статье проанализированы, обследованы и проанкетированы 217 пациентов, в возрасте от 30 до 89 лет, жителей города Челябинска и области с подтверждённым диагнозом злокачественного новообразования орофарингеальной зоны, из которых 127 человек
составили мужчины и 90- женщины. Из общего количества пациентов 30% первично обратились к врачу – стоматологу. Наибольшее число случаев злокачественных новообразований определяется в возрасте от 50 до 69 лет у обоих полов. Пациенты,
проживающие в Челябинске, статистически значимо (р<0,05) реже встречались, в совокупности,по обращаемости, чем пациенты, проживающие в челябинской области. Первичные опухоли типа Т1 статистически встречались значимо (р≤0,05)чаще. Отсутствие региональных метастазов (N0)встречалось статистически значимо (р≤0,05) чаще.Также чаще статистически значимо выявлено новообразований с высокой степенью дифференцировкой клеток (G1). Наиболее чаще (р≤0,05) злокачественные новообразования локализовались на языке и губах. Ороговевающая форма плоскоклеточного рака встречалась статистически значимо (р<0,001) чаще.
Oncological processes of the head and neck are a large number of tumors with a different course and requiring different treatment. In advanced stages,this treatment can lead to loss of vital functions and disrupt the appearance of a person with the appearance of bone and soft tissue defects [3]. But if this process is detected at the very beginning with an asymptomatic course or at the fi rst stage of the disease, then in 95-97% of cases the neoplasm can be removed without disability [5]. At this stage in the development of modern medicine with the help of radiation therapy and endoscopic surgery, it is possible to effectively treat oncological processes of the head and neck at stages I and II [2, 6]. With regard to the use of endoscopic surgery, the risk of developing psychological trauma in patients is reduced due to the absence of large incisions [8]. In this article, 217 patients, aged 30 to 89 years old, residents of the city of Chelyabinsk and the region with a confi rmed diagnosis of malignant neoplasm of the oropharyngeal zone were analyzed, examined and questioned, of which 127 were men and 90 were women. Of the total number of patients, 30% fi rst consulted a dentist. The largest number of cases of malignant neoplasms is determined at the age of 50 to 69 years in both sexes. Patients living in Chelyabinsk were statistically signifi cantly (p<0.05) less likely to meet, in aggregate, in terms of accessibility than patients living in the Chelyabinsk region. Primary T1 tumors were statistically signifi cant (p≤0.05) more often. The absence of regional metastases (N0) was statistically signifi cant (p≤0.05) more often. Also, neoplasms with a high degree of cell differentiation (G1) were also more often statistically signifi cant. Most often (p≤0.05),malignant neoplasms were localized on the tongue and lips. The keratinizing form of squamous cell carcinoma occurred statistically signifi cantly (p<0.001) more often.
Oncological processes of the head and neck are a large number of tumors with a different course and requiring different treatment. In advanced stages,this treatment can lead to loss of vital functions and disrupt the appearance of a person with the appearance of bone and soft tissue defects [3]. But if this process is detected at the very beginning with an asymptomatic course or at the fi rst stage of the disease, then in 95-97% of cases the neoplasm can be removed without disability [5]. At this stage in the development of modern medicine with the help of radiation therapy and endoscopic surgery, it is possible to effectively treat oncological processes of the head and neck at stages I and II [2, 6]. With regard to the use of endoscopic surgery, the risk of developing psychological trauma in patients is reduced due to the absence of large incisions [8]. In this article, 217 patients, aged 30 to 89 years old, residents of the city of Chelyabinsk and the region with a confi rmed diagnosis of malignant neoplasm of the oropharyngeal zone were analyzed, examined and questioned, of which 127 were men and 90 were women. Of the total number of patients, 30% fi rst consulted a dentist. The largest number of cases of malignant neoplasms is determined at the age of 50 to 69 years in both sexes. Patients living in Chelyabinsk were statistically signifi cantly (p<0.05) less likely to meet, in aggregate, in terms of accessibility than patients living in the Chelyabinsk region. Primary T1 tumors were statistically signifi cant (p≤0.05) more often. The absence of regional metastases (N0) was statistically signifi cant (p≤0.05) more often. Also, neoplasms with a high degree of cell differentiation (G1) were also more often statistically signifi cant. Most often (p≤0.05),malignant neoplasms were localized on the tongue and lips. The keratinizing form of squamous cell carcinoma occurred statistically signifi cantly (p<0.001) more often.