OMFS, Aintree University Hospitals NHS Foundation Trust, United Kingdom.
Oral Oncol. 2012 Feb;48(2):149-54. doi: 10.1016/j.oraloncology.2011.11.002. Epub 2011 Dec 7.
We aim to compare radiological with histological tumour thickness (RTT with HTT) for oral squamous cell carcinoma (OSCC), and the ability of both to predict cervical metastasis. The MRI images and histopathology reports of 102 consecutive OSCC cases were compared and the relationship between RTT and HTT, calculated as a "shrinkage factor" by the gradient of the best fitting regression line. Most (69%) tumours appeared thicker on MRI than was revealed by histopathology. Shrinkage factor was 0.70 (interquartile range 0.63-0.77, correlation co-efficient 0.63) for all cases, 0.87 (IQR 0.80-0.95, CC 0.88) for tongue and 0.65 (IQR 0.49-0.82, CC 0.45) for floor of mouth sub-sites. RTT did not correlate well with the presence of nodal metastases in any sub-site, i.e. there was no clinically applicable cut-off value of RTT to determine the prescription of elective neck dissection. Although RTT has some predictable relationship with HTT, this varies between sub-sites with tongue the most accurately predicted shrinkage using axial MRI. It is not possible from either the MRI staging of neck or tumour thickness to safely determine the need for neck dissection in OSCC. It is necessary to re-evaluate the benefit of MRI as a staging investigation (particularly for early stage OSCC) and further explore the contribution of molecular biomarkers and ultrasound.
我们旨在比较口腔鳞状细胞癌（OSCC）的影像学肿瘤厚度（RTT）与组织学肿瘤厚度（HTT），并评估两者预测颈部转移的能力。比较了 102 例连续 OSCC 病例的 MRI 图像和组织病理学报告，并通过最佳拟合回归线的梯度计算 RTT 和 HTT 之间的关系，计算出一个“收缩因子”。大多数（69%）肿瘤在 MRI 上的表现比组织病理学上的更厚。所有病例的收缩因子为 0.70（四分位间距 0.63-0.77，相关系数 0.63），舌部为 0.87（四分位间距 0.80-0.95，相关系数 0.88），口底为 0.65（四分位间距 0.49-0.82，相关系数 0.45）。在任何亚部位，RTT 与淋巴结转移的存在均无良好相关性，即不存在可用于确定选择性颈清扫术处方的 RTT 截断值。尽管 RTT 与 HTT 有一定的可预测关系，但在不同亚部位之间存在差异，即轴向 MRI 最能准确预测舌部的收缩。无论是颈部 MRI 分期还是肿瘤厚度，都无法安全确定 OSCC 是否需要进行颈清扫术。有必要重新评估 MRI 作为分期检查的价值（特别是对于早期 OSCC），并进一步探索分子生物标志物和超声的作用。
