Ogura I, Kurabayashi T, Amagasa T, Okada N, Sasaki T
Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Japan.
Dentomaxillofac Radiol. 2002 Nov;31(6):339-43. doi: 10.1038/sj.dmfr.4600726.
To evaluate the significance of mandibular bone invasion by gingival carcinoma revealed by reformatted dental CT images as a prognostic indicator of cervical metastasis.
Thirty-two patients with squamous cell carcinoma of the lower gingiva were examined by dental CT. Cervical metastases and survival rates of these patients were analysed in relation to their clinical characteristics, histologic grading based on gingival biopsy, and mandibular bone invasion using reformatted dental CT imaging diagnoses prior to surgery. The dental CT images were classified into four types: Class I, no bone invasion; Class II, invasion confined to the alveolus; Class III, invasion extending between the alveolus and the mandibular canal; and Class IV, invasion beyond the mandibular canal.
Logistic multivariate regression analysis showed that bony invasion identified on dental CT images was a significant prognostic factor in cervical metastases (P=0.028). The 5-year overall survival rates of Classes I, II, III, and IV were 100% (n=9), 76.2% (n=9), 71.4% (n=7), and 28.6% (n=7), respectively.
The evaluation of mandibular bone invasion using dental CT images is useful as a prognostic indicator of cervical metastasis for patients with gingival carcinoma.
评估经重组牙科CT图像显示的牙龈癌下颌骨侵犯作为颈部转移预后指标的意义。
对32例下牙龈鳞状细胞癌患者进行牙科CT检查。分析这些患者的颈部转移情况和生存率，以及他们的临床特征、基于牙龈活检的组织学分级，和术前使用重组牙科CT成像诊断的下颌骨侵犯情况。牙科CT图像分为四种类型：I类，无骨侵犯；II类，侵犯局限于牙槽突；III类，侵犯延伸至牙槽突与下颌管之间；IV类，侵犯超出下颌管。
Logistic多因素回归分析显示，牙科CT图像上识别出的骨侵犯是颈部转移的一个重要预后因素（P = 0.028）。I类、II类、III类和IV类的5年总生存率分别为100%（n = 9）、76.2%（n = 9）、71.4%（n = 7）和28.6%（n = 7）。
使用牙科CT图像评估下颌骨侵犯对于牙龈癌患者颈部转移的预后指标是有用的。
