Marinelli John P, Van Gompel Jamie J, Link Michael J, Moore Eric J, Price Daniel L, Lees Katherine A, Kaczor Mark W, Janus Jeffrey R
Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
Department of Neurosurgery, Rochester, Minnesota, U.S.A.
Laryngoscope. 2018 Apr;128(4):864-870. doi: 10.1002/lary.26843. Epub 2017 Aug 22.
To determine if the laterality of primary tumors in patients with olfactory neuroblastoma (ONB) influenced the pattern and development of neck disease.
Using a retrospective cohort study design from 1994 to 2015, the primary tumors of patients who either presented with or developed neck disease were volumetrically analyzed using iPlan software (version 3.0.0, BrainLAB, Feldkirchen, Germany) by two independent observers. Agreement of volume-derived sidedness was assessed with a kappa statistic, whereas agreement in volume-derived degree of tumor laterality was evaluated with an intraclass correlation coefficient. A one-sample t test was used to assess the difference in dominant percentage between the two observers.
Sixty-one patients with histological diagnosis and treatment of ONB at our institution were identified. Twenty-four patients exhibited neck involvement, 13 of whom could be volumetrically analyzed. Tumors that were greater than 75% eccentric to one side all exhibited contralateral disease, whereas the majority of unilateral neck disease was associated with relatively midline masses. Within the entire cohort, ipsilateral level 2 lymph nodes displayed the highest involvement (83%, 20 of 24), followed by ipsilateral level 1 (54%, 13 of 24), contralateral level 2 (46%, 11 of 24), contralateral level 1 (21%, 5 of 24), and ipsilateral level 3 (21%, 5 of 24).
Ipsilateral neck involvement frequently was observed; however, the degree of ONB primary site laterality did not appear to have implications on the development of contralateral neck disease. Therefore, when considering elective therapy to the neck, ONB laterality should not be used to justify unilateral neck treatment.
确定嗅神经母细胞瘤（ONB）患者原发肿瘤的部位是否会影响颈部疾病的模式及发展。
采用回顾性队列研究设计，对1994年至2015年期间出现或发展为颈部疾病的患者的原发肿瘤，由两名独立观察者使用iPlan软件（版本3.0.0，BrainLAB，德国费尔德基兴）进行体积分析。用kappa统计量评估体积衍生的部位一致性，而用组内相关系数评估体积衍生的肿瘤部位程度一致性。采用单样本t检验评估两名观察者之间优势百分比的差异。
在我们机构确定了61例经组织学诊断和治疗的ONB患者。24例患者出现颈部受累，其中13例可进行体积分析。偏心于一侧超过75%的肿瘤均表现为对侧疾病，而大多数单侧颈部疾病与相对中线的肿块相关。在整个队列中，同侧2区淋巴结受累最多（83%，24例中的20例），其次是同侧1区（54%，24例中的13例）、对侧2区（46%，24例中的11例）、对侧1区（21%，24例中的5例）和同侧3区（21%，24例中的5例）。
经常观察到同侧颈部受累；然而，ONB原发部位的偏侧程度似乎对侧颈部疾病的发展没有影响。因此，在考虑对颈部进行选择性治疗时，不应以ONB的部位来证明单侧颈部治疗的合理性。
4。《喉镜》，2018年，第128卷：864 - 870页。
