中文摘要：

目的评价鼻咽癌原发肿瘤MRI横截面最大径（MDAPPT）的预后价值。方法搜集2005--2007年间初治、病理证实、无远处转移且行鼻咽部和颈部MRI扫描的鼻咽癌患者333例临床资料，在MRI上测量最大径，Logrank法单因素及Cox法多因素分析其与预后的关系。结果鼻咽癌T1、T2、T3、T4期患者MDAPPT中位数分别为21．2、30．0、38．0、52．3mm。全组MDAPPT≤30、〉30～50、〉50mm患者5年总生存（0S）率分别为81．3％、70．1％、51．5％（P=0．000），无进展生存（PFS）率分别为81．3％、70．0％、48．9％（P=0．000），无远处转移生存（DMFS）率分别为85．5％、86．5％、67．2％（P=0．000），无局部复发生存（LRFS）率分别为97．7％、91．5％、83．3％（P=0．013）。多因素分析发现MDAPPT是影响PFS、DMFS的预后因素。T3～T4期MDAPPT≤50、〉50mm患者5年OS和PFS及DMFS分别为69．4％、52．2％（P=0．004）和68．0％、49．6％（P=0．001）及84．0％、66．8％（P：0．001）。全组MDAPPT≤30mm患者中T1、T2、T3、T4期的5年LRFS分别为100％、95．8％、96．3％、100％（P=0．643）。结论MDAPPT是影响鼻咽癌PFS和DMFS的预后因素，MDAPPT是鼻咽癌T晚期患者的重要预后因素，不同T分期中MDAPPT小的局部控制率无差异。

英文摘要：

Objective To investigate the prognostic value of maximum diameter in axial plane of primary tumor （MDAPPT） on MRI in nasopharyngeal carcinoma （NPC）. Methods From 2005 to 2007, 333 patients with newly diagnosed and biopsy-proven NPC without distant metastasis, who underwent MRI scans of the nasopharynx and neck, were included in our study. MDAPPT was measured on MRI. The univariate analysis with the log-rank test and multivariate analysis with the Cox proportional hazards model were used to analyze the relationship between MDAPPT and prognosis. Results The median values of MDAPPT in patients with T1 , T2, T3, and T4 NPC were 21.2, 30.0, 38.0, and 52. 3 mm, respectively. For all patients with a MDAPPT of ≤30 mm, 〉 30--50 mm, and 〉 50 mm, the 5-year overall survival （OS） rates were 81.3% , 70. 1%, and 51.5% , respectively （P = 0. 000） ; the 5-year progression-free survival （PFS） rates were 81.3%, 70. 0%, and 48.9%, respectively （ P = 0. 000） ; the 5-year distant metastasis- free survival （DMFS） rates were 85.5%, 86. 5%, and 67.2%, respectively （P =0. 000） ;the 5-year local relapse-free survival （LRFS） rates were 97.7%, 91.5%, and 83.3%, respectively （ P = 0. 013 ）. The multivariate analysis showed that MDAPPT was a prognostic factor for PFS and DMFS. For the T3-T4 patients with a MDAPPT of ≤50 mm and 〉50 mm, the 5-year OS rates were 69.4% and 52. 2% （P =0. 004）, the 5-year PFS rates were 68. 0% and 49. 6% （ P = 0. 001 ）, and the 5-year DMFS rates were 84. 0% and 66. 8% （P=0. 001）. In the patients with a MDAPPT ≤30 mm, the 5-year LRFS rates for those with T1, T2 , T3 , and T4 NPC were 10 0 % , 9 5.8 % , 9 6.3 % , and 10 0 % , respectively （ P = 0. 6 4 3 ）. Conclusions MDAPPT is a prognostic factor for PFS and DMFS in NPC, and it is an important prognostic factor in patients with T3-T4 NPC. In the NPC patients with a small MDAPPT, local control rate varies little in different T stages.