Nagasawa H
First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokyo Medical and Dental University.
Kokubyo Gakkai Zasshi. 1999 Mar;66(1):98-106. doi: 10.5357/koubyou.66.98.
Recent progress in ultrasonography has enabled to provide high-resolution images of superfical regions. In this study, the usefulness of ultrasonography using a high frequency probe for squamous cell carcinoma of the tongue was evaluated. Thirty normal adult subjects were examined to study ultrasonographic findings of normal tongue. The pattern of the normal tongue showed clearly three different zones, corresponding to three layers; mucosal epithelium, proper lamina and tongue muscle. The mean and standard deviation of epithelium thickness was 2.1 +/- 0.6 mm. The ultrasonographic findings for tongue carcinoma in 104 patients were evaluated. The ultrasonographic pattern of tongue carcinoma showed a hypoechoic structure as compared with surrounding tongue muscle. Depth of invasion defined as the distance between normal mucosal surface and the deepest point in 59 patients was measured. The mean and standard deviation of depth of invasion measured by ultrasonography was 8.1 +/- 4.0 mm. The depth of invasion increased with T-stage. The difference of tumor depth between T1 and T2, or T1 and T3 was statistically significant (p < 0.001). A significant correlation (p < 0.001) was obtained between depth of invasion measured by ultrasonography and that measured by histological sections. In the group of patients with the tumor depth exceeding 8 mm (mean depth), the lymph node metastasis rate was 75.0% (15/20). In the group of patients with the depth of less than 8 mm, the incidence of metastasis was 29.8% (14/47). The difference between the two groups was statistically significant (p < 0.001). The 5-year survival rate calculated by the Kaplan-Meier method was 45.7% in patients with the depth exceeding 8 mm and was 87.5% in patients with the depth of less than 8 mm. The difference was statistically significant (p < 0.001). In conclusion, ultrasonography using a high-resolution probe was very useful for evaluation of squamous cell carcinoma of the tongue, and depth of invasion measured by ultrasonography could be a predictive factor for cervical lymph node metastasis and patient survival rate.
超声检查技术的最新进展已能够提供浅表区域的高分辨率图像。在本研究中，评估了使用高频探头的超声检查对舌鳞状细胞癌的诊断价值。对30名正常成年受试者进行检查，以研究正常舌的超声检查结果。正常舌的图像清晰显示出三个不同区域，对应于三层结构：黏膜上皮、固有层和舌肌。上皮厚度的平均值和标准差为2.1±0.6毫米。对104例舌癌患者的超声检查结果进行了评估。与周围舌肌相比，舌癌的超声图像表现为低回声结构。测量了59例患者的浸润深度，定义为正常黏膜表面与最深点之间的距离。超声测量的浸润深度平均值和标准差为8.1±4.0毫米。浸润深度随T分期增加。T1与T2或T1与T3之间的肿瘤深度差异具有统计学意义（p<0.001）。超声测量的浸润深度与组织学切片测量的浸润深度之间存在显著相关性（p<0.001）。在肿瘤深度超过8毫米（平均深度）的患者组中，淋巴结转移率为75.0%（15/20）。在深度小于8毫米的患者组中，转移发生率为29.8%（14/47）。两组之间的差异具有统计学意义（p<0.001）。采用Kaplan-Meier法计算的5年生存率，深度超过8毫米的患者为45.7%，深度小于8毫米的患者为87.5%。差异具有统计学意义（p<0.001）。总之，使用高分辨率探头的超声检查对舌鳞状细胞癌的评估非常有用，超声测量的浸润深度可能是颈部淋巴结转移和患者生存率的预测因素。
