Charlin B, Brazeau-Lamontagne L, Guerrier B, Leduc C
Department of Otolaryngology, University of Sherbrooke, Quebec, Canada.
J Otolaryngol. 1989 Oct;18(6):283-8.
In order to assess the value of the systematic use of CT scan in the workup for laryngeal cancer, a retrospective study was conducted on 66 consecutive previously untreated cases of laryngeal cancer. Endoscopic and CT scan findings were systematically compared. The areas of particular difficulty in CT scan assessment are described. CT scan alone understaged laryngeal cancers in 10.6% of cases, all of them being superficial spreading tumors within the larynx or in the juxtalaryngeal areas. CT scan worsened the staging in 22.7% of cases, all of them being deep invasions overlooked by endoscopy. CT was most useful in lesions initially classified as T2 and T3, which included all those reclassified by CT. None of the T1 lesions was upgraded after CT, and systematic use of CT for this stage is not warranted. CT scan workup changed the therapeutic attitude in 10 of the 66 patients (15.1%), causing a switch to conservative surgery in seven patients and total laryngectomy with radiotherapy for the three others. CT was also valuable in choosing the most suitable technique for conservation surgery.
为评估在喉癌检查中系统使用CT扫描的价值，对66例连续的未经治疗的喉癌患者进行了一项回顾性研究。对内镜检查和CT扫描结果进行了系统比较。描述了CT扫描评估中特别困难的区域。仅CT扫描在10.6%的病例中对喉癌分期过低，所有这些病例均为喉内或喉旁区域的浅表扩散性肿瘤。CT扫描在22.7%的病例中使分期恶化，所有这些病例均为内镜检查遗漏的深部浸润。CT对最初分类为T2和T3的病变最有用，其中包括所有经CT重新分类的病变。CT检查后，没有T1病变被升级，因此对于该阶段不保证系统使用CT。CT扫描检查改变了66例患者中10例（15.1%）的治疗态度，导致7例患者转而接受保守手术，另外3例患者接受全喉切除加放疗。CT在选择最合适的保留手术技术方面也很有价值。
