Marchi Filippo, Filauro Marta, Iandelli Andrea, Carobbio Andrea Luigi Camillo, Mazzola Francesco, Santori Gregorio, Parrinello Giampiero, Canevari Frank Rikky Mauritz, Piazza Cesare, Peretti Giorgio
IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy.
Front Oncol. 2020 Feb 4;9:1571. doi: 10.3389/fonc.2019.01571. eCollection 2019.
Preoperative assessment is critical to decide the most adequate surgical strategy for oral squamous cell carcinoma (SCC). Magnetic resonance (MR) and intraoral ultrasonography (US) have been reported to be of great value for preoperative estimation of depth of invasion (DOI) and/or tumor thickness (TT). This review aims to analyze the accuracy of MR and intraoral US in determining DOI/TT in oral SCC, by assuming histological evaluation as the reference method. The procedure was conducted following the modified 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We performed a systematic search of papers on PubMed, Scopus, Web of Science, and Cochrane Library databases until July 31st, 2019. For quantitative synthesis, we included nine studies (487 patients) focused on MR, and 12 (520 patients) focused on intraoral US. The Pearson correlation coefficient () between DOI/TT evaluated with MR or intraoral US was assumed as effect size. A meta-analysis (MA) for each study group (MR and US) was performed by using the random-effects models with the DerSimonian-Laird estimator and -to- transformation. In the MA for MR studies, a high heterogeneity was found ( = 94.84%; = 154.915, < 0.001). No significant risk of bias occurred by evaluating funnel plot asymmetry ( = 0.563). The pooled (overall) of the MR studies was 0.87 (95% CI from 0.82 to 0.92), whereas the pooled -to- transformed was 1.44 (95% CI from 1.02 to 1.85). In the MA for US studies a high heterogeneity was found ( = 93.56%; = 170.884, < 0.001). However, no significant risk of bias occurred ( = 0.779). The pooled of the US studies was 0.96 (95% CI from 0.94 to 0.97), whereas the pooled -to- transformed was 1.76 (95% CI from 1.39 to 2.13). These outputs were confirmed in additional MA performed by enrolling only MR ( = 8) and US ( = 11) studies that evaluated TT. MR and intraoral US seem to be promising approaches for preoperative assessment of DOI/TT in oral SCC. Remarkably, a higher pooled and -to- transformed were observed in the intraoral US studies, suggesting that this approach could be more closely related to histopathological findings.
术前评估对于确定口腔鳞状细胞癌（SCC）最合适的手术策略至关重要。据报道，磁共振（MR）和口腔内超声检查（US）在术前评估浸润深度（DOI）和/或肿瘤厚度（TT）方面具有重要价值。本综述旨在通过将组织学评估作为参考方法，分析MR和口腔内US在确定口腔SCC的DOI/TT方面的准确性。该程序按照修改后的2009年系统评价和Meta分析的首选报告项目（PRISMA）声明进行。我们在PubMed、Scopus、Web of Science和Cochrane图书馆数据库中对截至2019年7月31日的论文进行了系统检索。为了进行定量综合分析，我们纳入了9项专注于MR的研究（487例患者）和12项专注于口腔内US的研究（520例患者）。将通过MR或口腔内US评估的DOI/TT之间的Pearson相关系数（）作为效应量。使用带有DerSimonian-Laird估计器和-到-转换的随机效应模型对每个研究组（MR和US）进行Meta分析（MA）。在MR研究的MA中，发现高度异质性（= 94.84%；= 154.915，< 0.001）。通过评估漏斗图不对称性未发现显著的偏倚风险（= 0.563）。MR研究的合并（总体）为0.87（95%CI为0.82至0.92），而合并的-到-转换为1.44（95%CI为1.02至1.85）。在US研究的MA中发现高度异质性（= 93.56%；= 170.884，< 0.001）。然而，未发现显著的偏倚风险（= 0.779）。US研究的合并为0.96（95%CI为0.94至0.97），而合并的-到-转换为1.76（95%CI为1.39至2.13）。在仅纳入评估TT的MR（= 8）和US（= 11）研究的额外MA中证实了这些结果。MR和口腔内US似乎是术前评估口腔SCC的DOI/TT的有前景的方法。值得注意的是，在口腔内US研究中观察到更高的合并和-到-转换，表明这种方法可能与组织病理学结果更密切相关。
