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词条 Oropharyngeal cancer
释义

  1. Signs and symptoms

  2. Risk factors

  3. Pathophysiology

  4. Diagnosis

     Squamous cell carcinomas  Stages  Stage 0 carcinoma in situ  Stage 1  Stage 2  Stage 3  Stage 4A  Stage 4B  Stage 4C 

  5. Prognosis

  6. Society and culture

  7. See also

  8. References

  9. Bibliography

  10. External links

{{Infobox medical condition (new)
| name =
| synonyms =
| image =
| caption = Microscope image of tumour showing HPV positivity by in situ hybridization
| alt = Image of human papilloma virus associated oropharyngeal cancer, under a microscope. The tissue has been stained to show the presence of the virus by in situ hybridisation
| symptoms = Sore or blister in back of mouth, difficulty with speech, swallowing or breathing, swelling in neck, loss of appetite, loss of weight, and weakness
| complications =
| onset =
| duration =
| types =
| causes = Human papilloma virus
| risks =
| diagnosis = Endoscopy, biopsy, staining for p16, CT scan
| differential =
| prevention = Vaccination
| treatment = Surgery, radiation, chemotherapy
| medication =
| prognosis =
| frequency =
| deaths =
}}Oropharyngeal cancer is a disease in which cancer form in the tissues of the throat (oropharynx). The oropharynx is the middle part of the throat that includes the base of the tongue, the tonsils, the soft palate, and the walls of the pharynx.[1] Oropharyngeal cancers can be divided into two types, HPV-positive, which are related to human papillomavirus infection, and HPV-negative cancers, which are usually linked to alcohol or tobacco use.[2]

Signs and symptoms

The possible signs of oropharyngeal cancer are:[1][3][4]

  • A sore throat that persists for over 2 weeks
  • Throat pain or difficulty swallowing
  • Unexplained rapid weight loss
  • Voice changes (more hoarse)
  • Ear pain
  • A lump in the back of the throat or mouth
  • A lump in the neck
  • A dull pain behind the sternum
  • Persistent Cough
  • Breathing problems
  • Hoarseness or other changes in the voice

Risk factors

The risk factors that can increase the risk of developing oropharyngeal cancer are:[3]

  • HPV infection
  • Smoking and chewing tobacco
  • Heavy alcohol use
  • A diet low in fruits and vegetables
  • Chewing betel quid, a stimulant commonly used in parts of Asia
  • Mucosal infection with human papilloma virus (HPV) (HPV-mediated oropharyngeal cancer)[5]
  • Plummer-Vinson syndrome
  • Poor nutrition
  • Asbestos exposure

Certain genetic changes including: P53 mutation and CDKN2A (p16) mutations.[6]

High-risk lesions:

  • Erythroplakia
  • Speckled erythroplakia
  • Chronic hyperplastic candidiasis

Medium-risk lesions:

  • Oral submucosal fibrosis
  • Syphilitic glossitis
  • Sideropenic dysphagia (or Paterson-Kelly-Brown syndrome)

Low-risk lesions:

  • Oral lichen planus
  • Discoid lupus erythematosus
  • Discoid keratosis congenita

Pathophysiology

The cancer can spread three ways:[3]

  • Cancer invades the surrounding normal tissues.
  • Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
  • Cancer invades the veins and capillaries and travels through the blood to other places in the body.

Diagnosis

Squamous cell carcinomas

Oropharyngeal squamous cell carcinomas (OPSCC) are a type of head and neck cancer that begins in the oropharynx, the middle part of the throat that includes the soft palate, the base of the tongue, the tonsils, and the side and back wall of the throat.[7] Squamous cell cancers of the tonsils are more strongly associated with human papillomavirus infection than are cancers of other regions of the head and neck.

Stages

The National Cancer Institute (2016) provides the following definition:{{sfn|NCI|2016}}

Stage 0 carcinoma in situ

Abnormal cells are found in the lining of the oropharynx. These may become cancer and spread into nearby normal tissue.

Stage 1

Cancer has formed and is 20 mm or smaller and has not spread outside the oropharynx.

Stage 2

Cancer has formed and is larger than 20 mm, but not larger than 40 mm. Also, it has not yet spread outside the oropharynx.

Stage 3

  • Cancer is larger than 40 mm and has not spread outside the oropharynx.
  • Any size and has spread to only one lymph node on the same side of the neck as the cancer. The lymph node with cancer is 30 mm or smaller.

Stage 4A

  • Cancer has spread to tissues near the oropharynx, including the larynx (voice box), roof of the mouth, lower jaw, muscle of the tongue, or central muscles of the jaw, and may have spread to one or more nearby lymph nodes; none is larger than 60 mm.
  • Cancer is any size and has spread to one lymph node that is larger than 30 mm, but not larger than 60 mm on the same side of the neck as the cancer or to more than one lymph node, none larger than 60 mm, on one of both sides of the neck.

Stage 4B

  • Cancer surrounds the main artery in the neck or has spread to bones in the jaw or skull, to muscle in the side of the jaw, or to the upper part of the throat behind the nose, and may have spread to nearby lymph nodes.
  • Cancer has spread to a lymph node that is larger than 60 mm and may have spread to tissues around the oropharynx.

Stage 4C

Cancer has spread to other parts of the body; the tumor may be any size and may have spread to lymph nodes.

Prognosis

People with HPV-related oropharyngeal cancer tend to have higher survival rates.[2] The prognosis for people with oropharyngeal cancer depends on the age and health of the person and the stage of the disease. It is important for people with oropharyngeal cancer to have follow-up exams for the rest of their lives, as cancer can occur in nearby areas. In addition, it is important to eliminate risk factors such as smoking and drinking alcohol, which increase the risk for second cancers.[1]

Society and culture

  • In 1989, Monty Python member Graham Chapman died of oropharyngeal cancer, on the eve of Monty Python's 20th anniversary.
  • In 1995, actress Lana Turner died from oropharyngeal cancer after a three-year battle with the disease.[8][9]
  • In 2010, American actor Michael Douglas reported to have oropharyngeal cancer.[10]
  • In 2014, Japanese musician and composer Ryuichi Sakamoto released a statement indicating that he had been diagnosed with oropharyngeal cancer in late June of the same year.[11]
  • In 2014, American musician and lead guitar player of Green Day, Jason White, was diagnosed with oropharyngeal cancer on December 3.[12][13]
  • In 2015, British musician Bruce Dickinson was diagnosed, and took a one-year break from Iron Maiden while undergoing treatment.
  • In 2017, Rob Derhak, bassist of the jam band moe, was diagnosed, prompting the band to go on indefinite hiatus.[14]

See also

  • Head and neck cancer
  • Cancer of the larynx
  • Thyroid cancer

References

1. ^1 2 {{cite web| url = http://my.clevelandclinic.org/disorders/Oropharyngeal_Cancer/hic_Oropharyngeal_Cancer.aspx| title = Oropharyngeal Cancer Overview| publisher = Cleveland Clinic| date=2007-09-07| accessdate = 2011-04-18}}
2. ^1 {{cite web|author = Christian Nordqvist| date = October 4, 2011 | title = HPV Linked Oropharyngeal Cancer Rates Rise Dramatically | publisher = Medical News Today | url = http://www.medicalnewstoday.com/articles/235446.php.}}
3. ^1 2 {{cite web|url = http://www.cancer.gov/cancertopics/pdq/treatment/oropharyngeal/patient/|title = Oropharyngeal Cancer Treatment (PDQ®)|publisher = National Cancer Institute|accessdate = 2011-04-18}}
4. ^{{Cite web|url=https://www.mdanderson.org/cancer-types/throat-cancer.html|title=Throat Cancer|website=MD Anderson Cancer Center|language=en|access-date=2019-02-12}}
5. ^{{Cite journal | pmid = 22782230| year = 2012| author1 = Isayeva| first1 = T| title = Human papillomavirus in non-oropharyngeal head and neck cancers: A systematic literature review| journal = Head and Neck Pathology| volume = 6 Suppl 1| pages = S104–20| last2 = Li| first2 = Y| last3 = Maswahu| first3 = D| last4 = Brandwein-Gensler| first4 = M| doi = 10.1007/s12105-012-0368-1| pmc = 3394168}}
6. ^{{cite journal |vauthors=Helgadottir H, Höiom V, Jönsson G, Tuominen R, Ingvar C, Borg A, Olsson H, Hansson J | title = High risk of tobacco-related cancers in CDKN2A mutation-positive melanoma families | journal = J Med Genet | volume = 51 | issue = 8 | pages = 545–52 | date = August 2014 | pmid = 24935963 | doi = 10.1136/jmedgenet-2014-102320 | pmc=4112445}}
7. ^What Are Oral Cavity and Oropharyngeal Cancers? {{webarchive|url=https://web.archive.org/web/20100619052745/http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_oral_cavity_and_oropharyngeal_cancer_60.asp |date=2010-06-19 }}
8. ^{{cite news|title=Movie star Lana Turner part of Hollywood lore|date=June 30, 1995|work=Milwaukee Journal Sentinel|page=6B}}
9. ^{{cite news|url=https://news.google.com/newspapers?id=cCZZAAAAIBAJ&sjid=_EYNAAAAIBAJ&pg=2826,3112750&dq=lana+turner+throat+cancer&hl=en|title=Lana Turner reveals she has throat cancer|date=May 26, 1992|work=The Union Democrat|page=5A|accessdate=June 25, 2017|via=Google News}} {{Open access}}
10. ^{{cite web|url = http://www.webmd.com/cancer/news/20100901/throat-cancer-faq|title = Michael Douglas and Throat Cancer FAQ|last = DeNoon|first = Daniel J.|work = WebMD Health News|publisher = WebMD|date = September 1, 2010|accessdate = 2011-04-18}}
11. ^{{cite web|url = http://www.webmd.com/cancer/news/20100901/throat-cancer-faq|title = Announcement from commons|last = Sakamoto|first = Ryuichi|work = WebMD Health News|date = July 10, 2014|accessdate = 2014-08-06}}
12. ^{{cite web|url=https://www.facebook.com/bigcatsinarkansas/photos/a.166475096711505.44149.153515688007446/1025048110854195/?type=1&permPage=1 | title=The Big Cats — Timeline Photos | website=www.facebook.com|publisher=The Big Cats|accessdate=6 December 2014|date=3 December 2014}}
13. ^{{cite web|last1=White|first1=Janna|title=Jason White has been diagnosed with cancer|url=http://www.greendayauthority.com/news/4993/|website=www.greendayauthority.com|publisher=Green Day Authority|accessdate=6 December 2014}}
14. ^{{Cite news|url=https://www.jambase.com/article/moe-announces-indefinite-hiatus-following-rob-derhak-cancer-diagnosis|title=moe. Announces Indefinite Hiatus Following Rob Derhak Cancer Diagnosis|date=2017-07-17|work=JamBase|access-date=2017-07-18|language=en-US}}

Bibliography

{{refbegin}}
  • {{cite web|title=Oropharyngeal Cancer Treatment|url=https://www.cancer.gov/types/head-and-neck/patient/oropharyngeal-treatment-pdq#section/_22|website=Head and neck Cancer - Patient version|publisher=National Institutes of Health - National Cancer Institute|accessdate=12 June 2017|date=December 2016|ref={{harvid|NCI|2016}}}}
{{refend}}

External links

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}}{{Tumors of lip, oral cavity and pharynx}}{{DEFAULTSORT:Oral And Maxillofacial Surgery}}

2 : Otorhinolaryngology|Head and neck cancer
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