Righini C, Mouret P, Wu D, Blanchet C, Reyt E
Service ORL, CHU de Grenoble, BP 217, 38043 Grenoble.
Ann Otolaryngol Chir Cervicofac. 2001 Dec;118(6):359-64.
The purpose of our study was to determine the position and value of ultrasound scan of the liver in the initial check-up of patients treated for a squamous cell carcinoma of the upper respiratory and digestive tract.
Our study is based on a retrospective review of 267 patients (249 males and 18 females) managed in the E.N.T. Department of Grenoble universitary hospital from 1993 to 1995 for a upper respiratory and digestive tract malignant tumor. No patient has been previously treated. The site of the primary tumor was: the oropharynx (108 cases), the hypopharynx (88 cases), the oral cavity (44 cases), the larynx (20 cases), the rhinopharynx (6 cases) and the cervical oesophagus (1 case). Endoscopic procedure with biopsy was performed for all the patients. Histologic examination revealed an invasive squamous cell carcinoma in all the cases. The complete check up included a ultrasound scan of the liver and a chest X-ray for all the patients.
Ultrasound scan of the liver revealed one or several metastases in 4 cases (1.5%). The primary tumor was hypopharyngeal in 3 cases (2 stages III, 1 stage IV) and oropharyngeal in 1 case (stage III). In three cases, carcinoma was poorly differentiated. Ultrasound scan of the liver was doubtful for 8 patients (3%). The primary tumor was oropharyngeal in 6 cases (1 stage I, 3 stages III, 2 stages IV), laryngeal in 1 case (stage III) and hypopharyngeal in case (stage IV). In six cases carcinoma was well differentiated. All the complementary examinations concluded to a benign liver disease, with a mean diagnosis delay of 4 weeks for the 8 patients. The mean follow-up duration of the 8 patients was 22 months (range 9 to 42 months). None presented any metastases during the follow up.
Our results compared with those of the literature revealed that ultrasound scan of the liver is a few specific examination which may be recommended for hypopharyngeal tumors, or for a large cervical adenopathy (N2 or N3), a poor differentiated tumor wherever the site of the primary tumor is.
我们研究的目的是确定肝脏超声扫描在上呼吸道和消化道鳞状细胞癌患者初检中的地位和价值。
我们的研究基于对1993年至1995年在格勒诺布尔大学医院耳鼻喉科治疗的267例上呼吸道和消化道恶性肿瘤患者（249例男性和18例女性）的回顾性分析。所有患者此前均未接受过治疗。原发肿瘤部位为：口咽（108例）、下咽（88例）、口腔（44例）、喉（20例）、鼻咽（6例）和颈段食管（1例）。所有患者均接受了内镜活检。组织学检查显示所有病例均为浸润性鳞状细胞癌。所有患者的全面检查包括肝脏超声扫描和胸部X光检查。
肝脏超声扫描发现4例（1.5%）有一处或多处转移。3例原发肿瘤在下咽（2例为III期，1例为IV期），1例在口咽（III期）。3例中，癌为低分化。8例患者（3%）肝脏超声扫描结果可疑。6例原发肿瘤在口咽（1例为I期，3例为III期，2例为IV期），1例在喉（III期），1例在下咽（IV期）。6例中，癌为高分化。所有补充检查均诊断为良性肝病，8例患者的平均诊断延迟为4周。8例患者的平均随访时间为22个月（9至42个月）。随访期间均未出现转移。
我们的结果与文献报道的结果相比表明，肝脏超声扫描是一项具有一定特异性的检查，对于下咽肿瘤、或大的颈部淋巴结肿大（N2或N3）、无论原发肿瘤部位何处的低分化肿瘤，均可推荐使用。
