Warner Giles C, Cox Graham J
Department of Otolaryngology/Head and Neck Surgery, The Radcliffe Infirmary, Oxford, UK.
J Otolaryngol. 2003 Apr;32(2):107-9. doi: 10.2310/7070.2003.37133.
To evaluate the role of chest radiography versus chest computed tomography (CT) in screening for pulmonary malignancy in advanced head and neck squamous cell carcinoma (HNSCC).
Retrospective review of imaging.
Head and neck cancer unit.
Over a period of 1 year, 26 patients with advanced HNSCC (T3/T4) were screened for pulmonary malignancy with both chest radiography and chest CT prior to definitive therapy.
Radiologic evidence of malignancy.
Twenty patients had a normal chest radiograph and a normal CT scan. Four patients had a normal chest radiograph but an abnormal CT scan. Three of these patients had a pulmonary malignancy and one had a suspicious lesion that resolved following surgery to the index tumour. Two patients had both an abnormal chest radiograph and CT scan. One of these had a pulmonary malignancy and one had a CT-guided biopsy of the chest lesion 4 weeks postoperatively, which was normal. Chest CT scanning therefore identified three chest malignancies that would have been missed by chest radiography alone.
Chest CT is an effective tool in screening for malignant pulmonary disease in patients with advanced head and neck cancer and should be used instead of chest radiography to avoid false-negative results.
评估胸部X线摄影与胸部计算机断层扫描（CT）在晚期头颈部鳞状细胞癌（HNSCC）肺部恶性肿瘤筛查中的作用。
影像学回顾性研究。
头颈癌科室。
在1年的时间里，对26例晚期HNSCC（T3/T4）患者在进行确定性治疗前，分别采用胸部X线摄影和胸部CT进行肺部恶性肿瘤筛查。
恶性肿瘤的放射学证据。
20例患者胸部X线摄影和CT扫描均正常。4例患者胸部X线摄影正常但CT扫描异常。其中3例患者患有肺部恶性肿瘤，1例有可疑病变，在对原发肿瘤进行手术后病变消失。2例患者胸部X线摄影和CT扫描均异常。其中1例患有肺部恶性肿瘤，1例在术后4周对胸部病变进行CT引导下活检，结果正常。因此，胸部CT扫描发现了3例仅通过胸部X线摄影会漏诊的胸部恶性肿瘤。
胸部CT是晚期头颈癌患者肺部恶性疾病筛查的有效工具，应使用胸部CT而非胸部X线摄影，以避免假阴性结果。
