Brouwer Jolijn, de Bree Remco, Hoekstra Otto S, Golding Richard P, Langendijk Johannes A, Castelijns Jonas A, Leemans C René
Department of Otolaryngology--Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Laryngoscope. 2005 Oct;115(10):1813-7. doi: 10.1097/01.mlg.0000174954.51514.b7.
OBJECTIVES/HYPOTHESIS: The detection of distant metastases during screening influences the choice of treatment in patients with head and neck squamous cell carcinoma. A previous study in the authors' institution showed that chest computed tomography (CT) scan was the most important screening technique. Different clinical risk factors in patients with head and neck squamous cell carcinoma for the development of distant metastases were identified.
Retrospective cohort study.
To evaluate the authors' diagnostic strategy, the accuracy of screening for distant metastases with chest CT in 109 consecutive patients with head and neck squamous cell carcinoma with risk factors between 1997 and 2000 was retrospectively analyzed.
Preoperative screening with CT revealed 20 patients (18%) with lung metastases and 1 liver metastasis. Despite negative screening with chest CT, 9 (11%) patients developed distant metastases within 12 months during follow-up. Sensitivity of the chest CT was 73%; the specificity was 80%.
Although chest CT frequently detects distant metastases, there seems to be a need for a more sensitive and whole-body screening technique.
目的/假设：在筛查过程中发现远处转移会影响头颈部鳞状细胞癌患者的治疗选择。作者所在机构之前的一项研究表明，胸部计算机断层扫描（CT）是最重要的筛查技术。已确定头颈部鳞状细胞癌患者发生远处转移的不同临床风险因素。
回顾性队列研究。
为评估作者的诊断策略，对1997年至2000年间连续109例具有风险因素的头颈部鳞状细胞癌患者进行胸部CT筛查远处转移的准确性进行了回顾性分析。
术前CT筛查发现20例（18%）患者有肺转移，1例有肝转移。尽管胸部CT筛查结果为阴性，但9例（11%）患者在随访的12个月内出现了远处转移。胸部CT的敏感性为73%；特异性为80%。
虽然胸部CT经常能检测到远处转移，但似乎需要一种更敏感的全身筛查技术。
