NLS-diagnostics Of Metatron 4025 Hunter And Nasopharynx Cancer

Problems in modern diagnostics of nasopharynx cancer (NPC) are pressing in the present time, it is proven by the fact that in 70% – 80% of patients treatment starts only at III-IV stages of disease, when average period of patients medical examination is 7 months before final diagnosis is identified.

Reasons of late diagnostics of nasopharynx cancer are: prolonged asymptomatic disease course, anatomico-topographic peculiarities of nasopharynx structure, imperfection of traditional widely used diagnostic techniques, difficulties in interpretation of tumorous and non-tumorous pathology visual pictures, low oncological vigilance of general therapists.

For the last decades NLS-diagnostic methods became widely spread in combined examination of patients; they demonstrate great diagnostic value at various diseases of digestive tract and respiratory organs. 3D NLS-graphy of upper respiratory tracts as diagnostic technique was developed last of all. In the future this examination method may be widely used in diagnostics of various nasopharynx pathologies and differential diagnostics of tumors of various geneses.

3D NLS-graphy allows therapists to visualize primary tumor, evaluate it spreading to pharynx walls, identify form of growth and detect genesis and character of neoplasm on the basis of resonance-entropy analysis (REA). Introduction of 3D NLS-graphy of upper respiratory tract into practical oncology made possible to develop and fulfill practical application of virtual microscopic researches with REA at the same time with routine histological examination. It extends significantly potentials of NLS-diagnostics, has an advantage over existing morphological methods of examination and allows to increase accuracy of diagnostics.

Nasopharynx neoplasms are characterized by variety of morphological forms, differing in their clinical course, histogenesis, applied methods of treatment and prognosis.

NPC is a combined group of tumors and there are many various morphological classifications with variety of used terms for it. Nowadays the most convenient in practical meaning is considered to be Micheau classification:

1. Non-differentiated cancer of nasopharyngeal type (variants: Schminke, Regaud, spindle-cell).

2. Epidermoid cancer (highly-, moderately- and low- differentiated ones).

3. Adenocarcinoma.

4. Cystadenocarcinoma.

5. Malignant mucoepidermoid tumor.

6. Others.

Indications for NLS-graphy fulfillment are symptoms related to tumor development in nasopharynx, which may be divided into nasal, auricular and neurological depending on localization.

Shortness of nasal breathing happens at tumor localization in nasopharynx. Increasing shortness of nasal breathing is accompanied by mucopurulent and purulent discharge with blood admixtures from nasal cavity. Number of complains for shortness of nasal breathing depends on exophytic component of tumor that closes openings and on additional inflammations. If surface is ulcerated periodically appearing bleeding can be detected; it becomes dangerous at angiofibroma.

If tumor is localized at side wall in front of auditory tube orifice, Trotter’s symptom complex may be developed: hearing impairment at affected side of head, neuralgia and anaesthesia of trigeminal nerve third branch’s branchlet and unilateral limitation of soft palate mobility. If tumor is localized near auditory tube orifice leading positions are taken by hearing impairment, tinnitus aurium, stuffiness in ear.

Neurological symptoms appear if tumor spreads to surrounding tissues. Most frequently neurological disorders develop if tumor spreads into skull base, posterior and side walls of nasopharynx, at the same time symptoms of almost all pairs of cerebral nerves affection are detected: develops paralysis of abducent nerve, facial nerve, appear immobility of one half of larynx, aglutition, disorders of sensitiveness, taste and tongue declination.

Abovementioned disorders develop at continuous presence of tumor. At initial stage of nasopharynx tumor development symptoms of diseases are missing, and the first clinical presentation of NPC is appearance of enlarged lymph nodes at neck in 50% of cases. This fact evidences that NPC is characterized by early regional metastatic disease. Size of primary tumor does not correlate with presence of regional metastatic disease. Even at small and superficial invasions of primary tumor, one can detect multiple metastases both from affection side and crossed and bilateral ones, which often localized in deep group of jugular lymph nodes. Large-sized metastases cause pain sensation and Gorner’s symptom complex is developed, characterized by constriction of palpebral fissure, pupil and eyeball retraction.

Examination of nasopharynx was carried out with modern devices Metatron 4025 Hunter.

Taking into consideration that in 50% of NPC study cases there are indistinct changes, it is necessary to carry out additional REA of pathological tissue area.

Growth forms at NPC are divided into endophytic, exophytic and combined forms, with ulceration or without ulceration of surface. Endophytic form of cancer usually looks like smooth slightly rising over surface infiltrate at NLS-picture, it looks like roundish moderately hyperchromic area (4-5 point at Fleindler’s scale). Ulceration of surface at endophytic form of cancer may be superficial and occupy up to few millimeters before it affects one or two walls and looks at NLS-picture like apparent hyperchromic area (in some cases of 5, but mainly of 6 points on Flendler’s scale). The most frequent form of cancer is localized on superior or side wall and is characteristic for non-differentiated cancer of nasopharyngeal type. The most difficult for differential diagnostics is endophytic form of cancer without ulceration, when it is presented only by small and slightly rising infiltrate. Such picture is quite infrequent and sometime it is very difficult to diagnose tumor even according to REA results. In our experience we had 6 cases when primary data did not allow to judge about cancer presence and only wave research of affected cells genome by high-frequency (40 GHz) devices allowed us to detect NPC.

Value of NLS-graphy is not only in feature of picture 3D-analysis, but in carrying out of high quality REA at ultramicroscopic areas of tumor without traumatic biopsy.

Together with study of nasopharynx pathology NLSpicture we started to develop resonance-wave aspects of diagnostics due to uninvestigated nature of this issue and difficulties of morphological differential diagnostics, especially of low-grade differentiated squamous cell carcinoma, low-grade differentiated cancer of nasopharyngeal type and lympho-proliferative diseases. At the same time it should by noted that it is wave spectrum character of low-grade differentiated cancer of nasopharyngeal type and tonsils that is more close to blast variants of lymphomas, and in some case only ultramicroscopic resonance-genetic analysis, and sometimes process generalization with hematopoietic system organs affection, give a possibility to carry out differentiated diagnostics.

Study of tumor cells cytomorphological peculiarities, character of their positioning, degree of differentiation and direction made possible to single out variants of wave spectrums, reflecting characteristics of histological structure of tumor various types.

Moderate-grade and high-grade differentiated squamous cell carcinoma which, was detected in 11% of our study cases, had typical spectral picture, just like cystoadenoid carcinoma (1.6%) and practically did not cause difficulties in interpretation of resonance-entropy analysis results.

Low-grade differentiated squamous cell carcinoma (67%) almost in all cases of monitoring causes certain difficulties in precise diagnosing and is one of hardly identified variants for resonance analysis. Resonance-wave picture of low-grade differentiated nasopharynx cancer is quite specific and allows therapist to diagnose not only form of tumor, but also to identify its organo-specificity by metastasis study without primarily detected nidus.

Results of carried out studies has proven high sensitivity of REA and detecting of low-grade differentiated cancer of nasopharyngeal type (78.3%), which allows us to recommend study continuation of NPC resonancewave peculiarities with low grade of cells differentiation in order to find more precise identification.

In potentials comparison of various diagnostic methods for detection of widely spread tumor pathology – NPC, positive conclusion on cancer presence was acquired: at otorhinolaryngological examination – in 32.5% of cases, at roentgenography – in 41% of cases, at 3D NLS-graphy – in 86.8 cases of study. Tumor was not detected on the basis of visual pictures of mirror examination – in 38.7% of cases, of NLS-graphic method – in 13.2% of cases. Acquired data clearly demonstrates high information value of 3D NLS-graphy of Metatron 4025 Hunter.