Department of Head & Neck Surgery and Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, and Department of Otorhinolaryngology, Academic Medical Centre, University of Amsterdam, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Eur Radiol. 2011 Jan;21(1):98-106. doi: 10.1007/s00330-010-1891-7. Epub 2010 Aug 3.
To investigate tumour-thickness measurement with an intra-operative ultrasound (US) probe.
A retrospective data analysis was undertaken for a total of 65 patients with a T1-2 oral cavity cancer, who were seen at a tertiary referral centre between 2004 and 2010. The correspondence between tumour thickness measured by ultrasonography and histopathology was assessed by Pearson's correlation coefficient, and also between tumour thickness and the development of neck metastasis.
In 11 cases, intra-oral measurement was not optimal due to limited mouth opening (n=2) or impossibility to depict the lesion (n=9). Tumour thickness measured by US correlated well with histopathology (n=23, R=0.93). Tumour thickness of ≤7 mm carries a risk of lymph node metastasis of 12%, whereas in tumours exceeding 7 mm this risk is 57% (p=0.001). Twenty-five percent developed neck metastasis and 19% had local recurrence.
Tumour thickness is an important predictive marker for lymph node metastases. As such, it can help in decision-making with regard to management of the primary tumour and neck. Based upon our findings, a wait-and-see policy is only warranted for superficial lesions with tumour thickness of less than 7 mm, but only if regular follow-up using US-guided aspiration of the neck is ensured.
探讨术中超声探头测量肿瘤厚度的方法。
对 2004 年至 2010 年间在一家三级转诊中心就诊的 65 例 T1-2 口腔癌患者进行回顾性数据分析。采用皮尔逊相关系数评估超声测量的肿瘤厚度与组织病理学之间的相关性，并评估肿瘤厚度与颈部转移的发展之间的相关性。
在 11 例中，由于张口受限（n=2）或无法描绘病变（n=9），口腔内测量不理想。US 测量的肿瘤厚度与组织病理学相关性良好（n=23，R=0.93）。厚度≤7mm 的肿瘤发生淋巴结转移的风险为 12%，而厚度超过 7mm 的肿瘤发生淋巴结转移的风险为 57%（p=0.001）。25%的患者发生颈部转移，19%的患者发生局部复发。
肿瘤厚度是淋巴结转移的重要预测标志物。因此，它可以帮助决策原发性肿瘤和颈部的管理。根据我们的发现，如果能确保定期使用超声引导下颈部抽吸进行随访，那么只有厚度小于 7mm 的浅表病变才值得等待观察，但前提是必须确保定期进行超声引导下颈部抽吸的随访。
