Scheer M, Kübler A C, Manawi N N, Reuther T, Zöller J E
Klinik und Poliklinik für Zahnärztliche Chirurgie und für Mund-, Kiefer- und Plastische Gesichtschirurgie, Universität zu Köln.
Mund Kiefer Gesichtschir. 2005 Sep;9(5):282-9. doi: 10.1007/s10006-005-0630-8.
The correlation between increasing tumor thickness and lymph node metastases as well as reduced survival in oral cancer has been proven by several studies. In most investigations the tumor thickness was assessed in histological sections. The aim of our prospective study was to assess tumor thickness in oral squamous cell carcinoma (OSCC) by intraoral ultrasonography and to evaluate the predictive value of tumor thickness for incidence of cervical lymph node involvement and survival.
A total of 64 patients with primary carcinomas of the oral cavity (stage I-IV) were included. Endosonographic assessment of patients was carried out using a 7.5-mHz probe (Hitachi EUP F334). The primary tumor could be visualized in all cases as a hypoechoic, sometimes irregular mass.
The average tumor thickness in all tumors was 14+/-7 mm. The N+ patients showed a greater tumor thickness (15+/-7 mm) than N0 OSCCs with 12+/-6 mm (p =0.032, t -test). Less advanced T1/T2 carcinomas revealed a tumor thickness of 10+/-5 mm in contrast to T3/T4 carcinomas with 16+/-7 mm (p <0.001, t-test). The overall survival was reduced in patients with tumors thicker than 14 mm (48.9 versus 28.3 months, p =0,0102 log rank test).
Although this technique facilitates the accurate assessment of tumor thickness in OSCC, only in less advanced tumors could endosonography provide additional information, since these tumors were not visible on CT or MRT scans. Nonetheless endosonography is a fast, cost-effective, and reliable technique for assessment of tumor extent in oral cancer.
多项研究已证实口腔癌中肿瘤厚度增加与淋巴结转移及生存率降低之间存在关联。在大多数研究中，肿瘤厚度是在组织学切片中评估的。我们前瞻性研究的目的是通过口腔内超声评估口腔鳞状细胞癌（OSCC）的肿瘤厚度，并评估肿瘤厚度对颈部淋巴结受累发生率和生存率的预测价值。
共纳入64例口腔原发性癌（I-IV期）患者。使用7.5兆赫兹探头（日立EUP F334）对患者进行超声内镜评估。在所有病例中，原发性肿瘤均可显示为低回声、有时不规则的肿块。
所有肿瘤的平均厚度为14±7毫米。N+患者的肿瘤厚度（15±7毫米）大于N0 OSCC患者的12±6毫米（p = 0.032，t检验）。与T3/T4期癌的16±7毫米相比，进展期较轻的T1/T2期癌的肿瘤厚度为10±5毫米（p < 0.001，t检验）。肿瘤厚度大于14毫米的患者总生存率降低（48.9个月对28.3个月，p = 0.0102，对数秩检验）。
尽管该技术有助于准确评估OSCC的肿瘤厚度，但仅在进展期较轻的肿瘤中，超声内镜才能提供额外信息，因为这些肿瘤在CT或磁共振成像扫描中不可见。尽管如此，超声内镜仍是一种快速、经济有效且可靠的评估口腔癌肿瘤范围的技术。
