University College London Hospital, Bloomsbury, London, UK.
University College London Hospital, Bloomsbury, London, UK.
Int J Oral Maxillofac Surg. 2021 Aug;50(8):981-988. doi: 10.1016/j.ijom.2020.11.002. Epub 2020 Dec 25.
Tumour depth is an important prognostic factor in head and neck cancer and has recently been included in the eighth edition of the Union for International Cancer Control TNM classification of malignant tumours for oral squamous cell carcinoma (OSCC). It is important to appraise the accuracy of depth assessments; however, there is little current evidence in the literature. Accurate depth assessment is particularly pertinent in cT1-T2N0 OSCC where it may influence neck management. A retrospective study was performed at two tertiary referral centres, in which surgically treated patients with cT1-T4N0 OSCC were audited. Preoperative tumour depth assessments from multimodality radiological staging scans were compared with the final histopathological depth. The predictive accuracy of intraoral ultrasound (IOUS), computed tomography (CT), and magnetic resonance imaging (MRI) for tumour depth was evaluated. Accuracy to within 3mm of the histopathological depth was seen in 56.7% of MRI scans and 57.1% of CT scans. IOUS appeared to have superior prediction, with 78.2% of measurements within 3mm. Over one third of CT and MRI imaging failed to detect a lesion; IOUS scans detected the lesions in all of these case. In conclusion, the reliability of preoperative imaging assessment of tumour depth should be considered when recommending treatment.
肿瘤深度是头颈部癌症的一个重要预后因素，最近已被纳入国际癌症控制联盟第八版口腔鳞状细胞癌（OSCC）的 TNM 肿瘤分类。评估深度评估的准确性很重要；然而，目前文献中的证据很少。在 cT1-T2N0 OSCC 中，准确的深度评估尤为重要，因为它可能影响颈部管理。在两个三级转诊中心进行了一项回顾性研究，对接受 cT1-T4N0 OSCC 手术治疗的患者进行了审核。将多模态影像学分期扫描的术前肿瘤深度评估与最终的组织病理学深度进行了比较。评估了口腔内超声（IOUS）、计算机断层扫描（CT）和磁共振成像（MRI）对肿瘤深度的预测准确性。MRI 扫描和 CT 扫描中，有 56.7%和 57.1%的测量值与组织病理学深度相差 3mm 以内。IOUS 似乎具有更好的预测能力，有 78.2%的测量值相差 3mm 以内。超过三分之一的 CT 和 MRI 成像未能检测到病变；IOUS 扫描在所有这些病例中都检测到了病变。总之，在推荐治疗时应考虑术前影像学评估肿瘤深度的可靠性。
