Department of Oncology 5073, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100-DK, Copenhagen, Denmark.
Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Eur Arch Otorhinolaryngol. 2022 Jan;279(1):521-526. doi: 10.1007/s00405-021-06890-7. Epub 2021 Jun 1.
Whole-body FDG-PET-CT is widely used at diagnosis of squamous cell carcinoma of the head and neck (SCCHN) but may identify suspicious lesions outside the neck that require investigation. This study evaluated the impact of smoking and P16-status on the incidence of malignant disease outside the head and neck region in newly diagnosed patients with SCCHN.
All PET-positive foci outside the head-neck area were registered in 1069 patients planned for postoperative or curative intent radiotherapy with whole-body FDG-PET/CT from 2006 to 2012. All patient files were retrospectively investigated and clinical parameters, tobacco use, HPV (P16)-status and subsequent malignant disease registered.
Malignancy outside the neck was diagnosed in 9% of smokers, 2% of never-smokers, and 5% of patients with P16-positive oropharyngeal squamous cell carcinoma (OPSCC). Clinically suspicious PET-positive foci outside the head-neck were malignant in 55% of smokers, 34% of never-smokers, and in 38% of P16-pos OPSCC. All but two patients with cancer occurring outside the head and neck region were smokers.
Malignancy outside the neck at diagnosis was more frequent in smokers compared to non-smokers or P16-pos OPSCC. A high proportion of clinically suspicious PET-positive foci were non-malignant.
全身 FDG-PET-CT 在头颈部鳞状细胞癌（SCCHN）的诊断中广泛应用，但可能会识别出颈部以外需要进一步检查的可疑病变。本研究评估了吸烟和 P16 状态对头颈部以外恶性疾病发生率的影响，该研究纳入了 2006 年至 2012 年期间计划接受术后或根治性放疗的 1069 例全身 FDG-PET/CT 阳性的新诊断 SCCHN 患者。
所有头颈部以外的 FDG-PET 阳性病灶均在 1069 例患者中登记，这些患者计划接受术后或根治性放疗，使用全身 FDG-PET/CT 进行检测，这些患者来自 2006 年至 2012 年。所有患者的病历均进行回顾性调查，并记录了临床参数、吸烟情况、HPV（P16）状态和随后的恶性疾病。
在吸烟者中，颈部以外的恶性肿瘤在 9%的患者中被诊断出来，在不吸烟者中为 2%，在 P16 阳性的口咽鳞状细胞癌（OPSCC）患者中为 5%。在吸烟者中，有 55%的临床可疑 PET 阳性的头颈部以外病灶是恶性的，在不吸烟者中为 34%，在 P16 阳性的 OPSCC 患者中为 38%。除了两名患者外，所有发生在头颈部以外区域的癌症患者均为吸烟者。
与不吸烟者或 P16 阳性的 OPSCC 相比，在诊断时颈部以外的恶性肿瘤在吸烟者中更为常见。很大一部分临床可疑的 PET 阳性病灶是非恶性的。
