Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Int J Oral Maxillofac Surg. 2010 May;39(5):436-9. doi: 10.1016/j.ijom.2010.02.008. Epub 2010 Mar 7.
This preliminary retrospective study evaluates the diagnostic value of cone-beam computed tomography (CBCT), as a potential standard preoperative procedure, in assessing mandibular invasion by oral squamous cell carcinoma (OSCC) compared with conventional preoperative panoramic radiography (PR), magnetic resonance imaging (MRI) and histological examination of the resection specimen (the golden standard). Between September 2006 and September 2009, 23 patients with histology proven primary OSCC, adjacent to or fixed to the mandible were included. The tumours were classified into four groups, ranging from no bone invasion to evident bone invasion. Sensitivity and specificity for PR were 55% (95% CI [0.350;0.619]) and 92% (95% CI 0.737;0.984]), respectively, both were significantly lower than the 91% (95% CI [0.740;0.909]) and 100% (95% CI [0.845;1]), respectively, for CBCT. MRI showed 82% sensitivity (95% CI [0.608;0.941]) and 67% specificity (95% CI [0.474;0.779]). CBCT has the potential to become a new diagnostic tool in the OSCC screening procedure to predict mandibular invasion or erosion, but its value may be limited by its relatively low sensitivity. A prospective study will start on 64 patients (alpha=0.05; power 0.8; effect size 0.5) to improve these results statistically.
本初步回顾性研究评估了锥形束 CT（CBCT）作为一种潜在的标准术前程序，在评估口腔鳞状细胞癌（OSCC）对下颌骨的侵犯方面的诊断价值，与常规术前全景片（PR）、磁共振成像（MRI）和切除标本的组织学检查（金标准）进行比较。2006 年 9 月至 2009 年 9 月，共纳入 23 例经组织学证实的原发性 OSCC 患者，这些肿瘤毗邻或固定在下颌骨。肿瘤分为 4 组，从无骨侵犯到明显骨侵犯。PR 的灵敏度和特异性分别为 55%（95%CI [0.350;0.619]）和 92%（95%CI 0.737;0.984]），均显著低于 CBCT 的 91%（95%CI [0.740;0.909]）和 100%（95%CI [0.845;1]）。MRI 显示出 82%的灵敏度（95%CI [0.608;0.941]）和 67%的特异性（95%CI [0.474;0.779]）。CBCT 有可能成为 OSCC 筛查程序中预测下颌骨侵犯或侵蚀的新诊断工具，但由于其灵敏度相对较低，其价值可能受到限制。一项针对 64 例患者的前瞻性研究（alpha=0.05；power 0.8；effect size 0.5）将开始进行，以统计上改善这些结果。
