Lozano Blesa University Hospital, Department of Otorhinolaryngology, Zaragoza, Spain.
Ernest LLuch Martín Hospital, Department of Otorhinolaryngology, Calatayud, Spain.
Braz J Otorhinolaryngol. 2021 Jan-Feb;87(1):11-18. doi: 10.1016/j.bjorl.2019.06.004. Epub 2019 Jul 6.
Head and neck squamous cell carcinoma is the seventh most common malignant tumor. The advances in treatment have improved the global survival rates in the past years, although the prognosis is still grave.
The aim of the present study is to evaluate the correlation between positron emission computed tomography and computed tomography at the time of staging a previously untreated head and neck squamous cell carcinoma, and to determine which of the two imaging techniques gives us more information at the time of initial diagnosis.
Data from all patients diagnosed in our hospital of head and neck squamous cell carcinoma by a biopsy of any location or unknown primary tumor was collected, between January 2012 and July 2017. In all cases, computed tomography and positron emission computed tomography were performed with a maximum of 30 days difference between them and patients had not received any prior treatment to staging. The stage given to each case was compared based solely on the physical examination, only on the computed tomography/positron emission computed tomography, with respect to the stage given by the tumor board, observing the concordance obtained through Cramer's V statistical test.
We performed a comparative analysis obtaining a correlation of 0.729 between the stage given by the tumor board and the one assigned based on the physical examination without imaging techniques. When only using computed tomography as an imaging method, the correlation was 0.848, whereas with only the use of positron emission computed tomography it was estimated at 0.957. When comparing the statistical association between staging using exclusively one of the two imaging techniques, correlation was 0.855.
Positron emission computed tomography is useful for the diagnosis of head and neck squamous cell carcinoma, improving the patient's staging especially when detecting cervical and distant metastases. Therefore, we consider that the use of positron emission computed tomography for the staging of patients with head and neck squamous cell carcinoma is a diagnostic test to be considered.
头颈部鳞状细胞癌是第七大常见恶性肿瘤。近年来，治疗的进步提高了全球的生存率，但预后仍然很严重。
本研究旨在评估在未经治疗的头颈部鳞状细胞癌分期时正电子发射计算机断层扫描和计算机断层扫描的相关性，并确定在初始诊断时哪一种成像技术提供更多信息。
收集了 2012 年 1 月至 2017 年 7 月期间在我院经活检确诊的头颈部鳞状细胞癌患者的所有数据，活检部位或未知原发灶。所有患者均在 30 天内完成了计算机断层扫描和正电子发射计算机断层扫描检查，且未接受任何治疗。仅根据体格检查、单独根据计算机断层扫描/正电子发射计算机断层扫描以及肿瘤委员会给出的分期来比较每个病例的分期，观察 Cramer's V 统计检验获得的一致性。
我们进行了对比分析，发现肿瘤委员会给出的分期与不使用影像学技术的体格检查给出的分期之间存在 0.729 的相关性。单独使用计算机断层扫描作为影像学方法时，相关性为 0.848，而仅使用正电子发射计算机断层扫描时，相关性估计为 0.957。当比较单独使用两种影像学技术之一进行分期的统计关联时，相关性为 0.855。
正电子发射计算机断层扫描对头颈部鳞状细胞癌的诊断有用，尤其是在检测颈部和远处转移时，可以改善患者的分期。因此，我们认为对头颈部鳞状细胞癌患者进行分期时使用正电子发射计算机断层扫描是一项值得考虑的诊断测试。
