Department of Otorhinolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea.
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Eur Radiol. 2017 Sep;27(9):3725-3732. doi: 10.1007/s00330-017-4750-y. Epub 2017 Feb 6.
We aimed to identify the clinical implications of nonspecific pulmonary nodules (NPNs) detected in the initial staging workup for patients with head and neck squamous cell carcinoma (HNSCC).
Medical records of patients who had been diagnosed and treated in our hospital were retrospectively analysed. After definite treatment, changes of NPNs detected on initial evaluation were monitored via serial chest computed tomography. The associations between NPNs and the clinicopathological characteristics of primary HNSCC were evaluated. Survival analyses were performed according to the presence of NPNs.
The study consisted of 158 (49.4%) patients without NPNs and 162 (50.6%) patients with NPNs. The cumulative incidence of probabilities of pulmonary malignancy (PM) development at 2 years after treatment were 9.0% and 6.2% in NPN-negative and NPN-positive patients, respectively. Overall and PM-free survival rates were not significantly different according to NPN status. Cervical lymph node (LN) involvement and a platelet-lymphocyte ratio (PLR) ≥126 increased the risk of PMs (both P <0.05).
NPNs detected in the initial evaluation of patients with HNSCC did not predict the risk of pulmonary malignancies. Cervical LN involvement and PLR ≥126 may be independent prognostic factors affecting PM-free survival regardless of NPN status.
• We aimed to identify the clinical implications of nonspecific pulmonary nodules (NPNs). • NPNs in head and neck cancer patients do not lead to pulmonary malignancies (PMs). • NPNs are not associated with overall or PM-free survival (PMFS). • Cervical lymph node involvement is an independent prognostic factor affecting PMFS. • Platelet-lymphocyte ratio ≥126 is another predictor of PMFS regardless of NPN presence.
本研究旨在探讨在头颈部鳞状细胞癌（HNSCC）患者初始分期检查中发现的非特异性肺结节（NPN）的临床意义。
回顾性分析我院收治的患者的病历资料。经过明确治疗后，通过连续胸部计算机断层扫描监测初始评估中发现的 NPN 变化。评估 NPN 与 HNSCC 患者临床病理特征之间的关系。根据是否存在 NPN 进行生存分析。
研究共纳入 158 例无 NPN 患者（49.4%）和 162 例有 NPN 患者（50.6%）。治疗后 2 年时，NPN 阴性和 NPN 阳性患者的肺恶性肿瘤（PM）发展概率的累积发生率分别为 9.0%和 6.2%。根据 NPN 状态，总生存率和 PM 无生存率无显著差异。颈部淋巴结（LN）受累和血小板-淋巴细胞比值（PLR）≥126 增加 PM 发生风险（均 P<0.05）。
在 HNSCC 患者的初始评估中发现的 NPN 并不能预测发生 PM 的风险。LN 受累和 PLR≥126 可能是独立的预后因素，影响 PM 无生存，而与 NPN 状态无关。
①我们旨在确定非特异性肺结节（NPNs）的临床意义。②头颈部癌症患者的 NPN 不会导致肺恶性肿瘤（PMs）。③NPN 与总生存率或 PM 无生存率（PMFS）无关。④颈部淋巴结受累是影响 PMFS 的独立预后因素。⑤血小板-淋巴细胞比值≥126 是 PMFS 的另一个预测因素，而与 NPN 存在与否无关。
