Ishibashi-Kanno Naomi, Yamagata Kenji, Uchida Fumihiko, Hasegawa Shogo, Yanagawa Toru, Bukawa Hiroki
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan.
Department of Oral and Maxillofacial Surgery, Toyokawa City Hospital, Yawata-cho noji 23, Toyokawa, 442-0857, Japan.
Oral Maxillofac Surg. 2017 Dec;21(4):391-396. doi: 10.1007/s10006-017-0644-z. Epub 2017 Aug 31.
The purpose of this study is to compare the value of screening for synchronous multiple primary cancers in other organs by esophagogastroduodenoscopy (EGD) or F-fluorodeoxyglucose positron-emission tomography (PET-CT) in patients newly diagnosed with oral cancer.
We retrospectively examined consecutive Japanese patients who were diagnosed with oral squamous cell carcinoma (OSCC) and were screened for synchronous multiple primary cancers in other organs by EGD and/or PET-CT between January 2010 and December 2015 at our institution. The study included 190 patients (106 males and 84 females) from 36 to 93 years of age (median age 68.8 years). The patients were screened by EGD, PET-CT, or both before beginning treatment for OSCC.
Of 190 Japanese patients with OSCC, 15 had multiple primary cancers: 13 patients had double cancer and two had triple cancers. The sites of the 17 multiple primary cancers were gastric (6), esophageal (4), and lung (3), and ovarian, colon, liver, and thyroid (1 each). All of the gastric and esophageal cancers were found by EGD and were not detected by PET-CT. For three patients, the detection of multiple cancers affected the treatment modality or order of treatment selected for the OSCC. In two cases, the oral cancer and multiple primary cancer(s) in another organ were resected simultaneously by joint surgical teams.
PET-CT for oral cancer patients is an effective supporting diagnostic tool. However, the ability of PET-CT has some limitations. Especially for early detection of the upper gastrointestinal cancers, it is necessary to be supplemented by EGD.
本研究旨在比较食管胃十二指肠镜检查（EGD）或F-氟脱氧葡萄糖正电子发射断层扫描（PET-CT）对新诊断口腔癌患者筛查其他器官同步性多原发性癌的价值。
我们回顾性研究了2010年1月至2015年12月期间在我院连续诊断为口腔鳞状细胞癌（OSCC）并通过EGD和/或PET-CT筛查其他器官同步性多原发性癌的日本患者。该研究纳入了190例患者（男性106例，女性84例），年龄在36至93岁之间（中位年龄68.8岁）。患者在开始OSCC治疗前接受了EGD、PET-CT或两者的筛查。
190例日本OSCC患者中，15例患有多原发性癌：13例为双癌，2例为三癌。17处多原发性癌的部位为胃（6处）、食管（4处）、肺（3处），卵巢、结肠、肝脏和甲状腺各1处。所有胃癌和食管癌均通过EGD发现，PET-CT未检测到。对于3例患者，多癌的检测影响了为OSCC选择的治疗方式或治疗顺序。在2例病例中，口腔癌和另一器官的多原发性癌由联合手术团队同时切除。
PET-CT对口腔癌患者是一种有效的辅助诊断工具。然而，PET-CT的能力有一些局限性。特别是对于早期检测上消化道癌，有必要用EGD进行补充。
