Jayasankaran Sandya Chirukandath, Chelakkot Prameela Govindalayathil, Karippaliyil Milind, Thankappan Krishnakumar, Iyer Subramaniya, Moorthy Srikanth
Department of Radiology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
Department of Radiation Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
Indian J Cancer. 2017 Jul-Sep;54(3):508-513. doi: 10.4103/ijc.IJC_319_17.
Preoperative imaging is mandatory for deciding the extent of surgery in tumors of oral tongue. Previous studies have shown the significance of depth of tumor invasion in predicting nodal involvement.
This prospective study aimed to assess the correlation between tumor dimensions in all three planes obtained through preoperative imaging and histopathological findings, as well as the correlation between these and pathological node positivity.
Fifty-nine consecutive patients with nonmetastatic, operable, squamous cell carcinoma of anterior two-thirds of the tongue were included in the study. Preoperative imaging findings were compared with pathological findings and analyzed.
Histopathological dimensions were concordant with imaging findings. Anteroposterior, transverse, and craniocaudal (CC) dimensions obtained through imaging showed a significant correlation with corresponding pathological findings (0.730, 0.621, 0.810, respectively; P < 0.001). Among all three, only CC dimension showed a significant correlation with pathological nodal involvement (odds ratio [OR] = 7.875, P = 0.03, relative risk = 0.236). Pathological tumor thickness of >3 mm had a positive predictive value of 54.9% for nodal involvement (OR = 7.875, P = 0.03).
With widespread availability of state-of-the-art magnetic resonance (MR) scanners, CC dimension needs to be emphasized as the most significant prognostic tumor parameter. Recent evidence, including our study, suggests that MR imaging is concordant with pathological findings, justifying its use in the pretreatment evaluation of oral tongue lesions.
术前影像学检查对于确定舌癌手术范围至关重要。既往研究表明肿瘤浸润深度在预测淋巴结受累方面具有重要意义。
本前瞻性研究旨在评估通过术前影像学检查获得的肿瘤在三个平面的尺寸与组织病理学结果之间的相关性，以及这些与病理淋巴结阳性之间的相关性。
本研究纳入了59例连续的非转移性、可手术切除的舌前三分之二鳞状细胞癌患者。将术前影像学检查结果与病理结果进行比较并分析。
组织病理学尺寸与影像学检查结果一致。通过影像学检查获得的前后径、横径和颅尾径（CC径）与相应的病理结果显示出显著相关性（分别为0.730、0.621、0.810；P < 0.001）。在这三个径线中，只有CC径与病理淋巴结受累显示出显著相关性（优势比[OR] = 7.875，P = 0.03，相对风险 = 0.236）。病理肿瘤厚度>3 mm对淋巴结受累的阳性预测值为54.9%（OR = 7.875，P = 0.03）。
随着先进磁共振（MR）扫描仪的广泛应用，CC径作为最重要的预后肿瘤参数需要得到重视。包括我们研究在内的最新证据表明，MR成像与病理结果一致，证明其在舌部病变术前评估中的应用价值。
