Lane A P, Buckmire R A, Mukherji S K, Pillsbury H C, Meredith S D
Division of Otolaryngology-Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7070, USA.
Otolaryngol Head Neck Surg. 2000 May;122(5):673-7. doi: 10.1016/S0194-5998(00)70194-X.
Carcinomas originating in the retromolar trigone (RMT) are uncommon and characterized by early spread. Determination of mandibular invasion is significant for planning therapy and determining prognosis. For oral cavity cancers in general, CT is reasonably accurate in assessing bone invasion. However, there is a paucity of information specifically addressing the value of CT in the RMT. In this study, the records of patients with biopsy-proven RMT carcinomas treated between 1984 and 1998 were reviewed with attention to preoperative CT scans and histopathologic findings during surgery. Half of the patients who were treated with primary resection had mandibular invasion. Bone invasion was not identified radiographically in 27% of patients with preoperative CT scans. The sensitivity of CT for bone involvement in RMT cancers was 50%, with a negative predictive value of 61.1%. The positive predictive value was 91.1%. These findings suggest that CT is a useful, but potentially inaccurate, predictor of bone invasion in the RMT.
起源于磨牙后三角区（RMT）的癌并不常见，其特点是早期扩散。确定下颌骨侵犯对于规划治疗方案和判断预后具有重要意义。对于一般的口腔癌，CT在评估骨侵犯方面具有相当高的准确性。然而，关于CT在RMT中的价值，具体信息却很少。在本研究中，回顾了1984年至1998年间经活检证实的RMT癌患者的记录，重点关注术前CT扫描和手术中的组织病理学发现。接受一期切除治疗的患者中有一半存在下颌骨侵犯。在术前进行CT扫描的患者中，27%的患者在影像学上未发现骨侵犯。CT对RMT癌骨受累情况的敏感性为50%，阴性预测值为61.1%。阳性预测值为91.1%。这些发现表明，CT是RMT骨侵犯的一个有用但可能不准确的预测指标。
