口腔和口咽鳞状细胞癌下颌骨侵犯的放射学评估。

Radiological assessment of mandibular invasion in squamous cell carcinoma of the oral cavity and oropharynx.

机构信息

Service d'ORL et de chirurgie cervico-faciale, CHU de Lille, université de Lille, hôpital Huriez, rue Michel-Polonovski, 59037 Lille, France.

Service de radiologie et imagerie interventionnelle, CHU de Lille, université de Lille, hôpital Huriez, rue Michel-Polonovski, 59037 Lille, France.

出版信息

Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Oct;136(5):361-366. doi: 10.1016/j.anorl.2019.05.005. Epub 2019 Jun 10.

DOI:10.1016/j.anorl.2019.05.005

PMID:31196801

Abstract

BACKGROUND

Preoperative assessment of mandibular bone invasion in squamous cell carcinoma of the oral cavity and oropharynx is crucial for optimizing bone resection. The principal aim of this study was to evaluate the diagnostic value of CT and MR imaging for the diagnosis of mandibular bone invasion compared to the histological reference. In addition, we assessed the survival impact of bone invasion.

PATIENTS AND METHODS

A single-center retrospective study included all consecutive patients treated by mandibular bone interruption for squamous cell carcinoma of the oral cavity and/or oropharynx.

RESULTS

Sixty-eight patients were included. Prevalence of bone invasion on histology was 43%. Sensitivity, specificity and positive and negative predictive value were respectively 70%, 71%, 66% and 76% for CT compared with histologic analysis, 83%, 50%, 59% and 78% for MRI, and 83%, 62% 62%, 83% for associated CT and MRI. The two tests showed good agreement, with kappa index 0.69 (95% CI, 0.49-0.89) (P<0.0001). There was no difference in overall survival (log-rank>0.70) between the groups with and without bone invasion.

CONCLUSION

CT and MRI are complementary for preoperative assessment of mandibular bone invasion, be it cortical and/or medullary, and in some cases may allow mandibular bone-sparing.

摘要

背景

口腔和口咽鳞状细胞癌术前评估下颌骨侵犯对优化骨切除至关重要。本研究的主要目的是评估 CT 和 MR 成像对诊断下颌骨侵犯的诊断价值，并与组织学参考进行比较。此外，我们评估了骨侵犯对生存的影响。

患者和方法

一项单中心回顾性研究纳入了所有因口腔和/或口咽鳞状细胞癌接受下颌骨中断治疗的连续患者。

结果

共纳入 68 例患者。组织学上骨侵犯的患病率为 43%。与组织学分析相比，CT 的敏感性、特异性、阳性预测值和阴性预测值分别为 70%、71%、66%和 76%，MRI 为 83%、50%、59%和 78%，联合 CT 和 MRI 为 83%、62%、62%和 83%。两种检测方法具有良好的一致性，kappa 指数为 0.69（95%CI，0.49-0.89）（P<0.0001）。有和无骨侵犯组之间的总生存率无差异（对数秩检验>0.70）。