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临床诊断标准与先进成像技术在预测口腔鳞状细胞癌颈淋巴结转移中的比较:一项基于磁共振成像的研究。

Clinical diagnostic criteria versus advanced imaging in prediction of cervical lymph node metastasis in oral squamous cell carcinomas: A magnetic resonance imaging based study.

作者信息

Lalfamkima F, Georgeno G L, Rao N Koteswara, Selvakumar Rajkumar, Devadoss Vimal Joseph, Rajaram Niroshini, Farid Shomaila, Lalchhuanawma T, Nayyar Abhishek Singh

机构信息

Consultant Dental Surgeon, Selection Grade, Dental Department, Civil Hospital, Aizawl, Mizoram, India.

Department of Oral and Maxillofacial Surgery, Rajas Dental College and Hospital, Kavalkinaru, Tirunelveli, India.

出版信息

J Carcinog. 2021 Apr 13;20:3. doi: 10.4103/jcar.JCar_27_20. eCollection 2021.

Abstract

CONTEXT AND AIM

The inaccuracies in clinical examination have been well documented, while advanced imaging modalities, including computed tomography and magnetic resonance imaging (MRI), have been shown to have superior diagnostic accuracy in detecting occult and nodal metastasis. The aim of the present study was to identify as well as evaluate the inaccuracies in clinical examination and of clinical diagnostic criteria in known cases of oral squamous cell carcinomas (OSCCs) with the help of MRI.

MATERIALS AND METHODS

A total of 24 patients attending as outpatients were included in the study, while clinically diagnosed and histopathologically proven cases of OSCC were examined clinically and then subjected to advanced imaging with the help of MRI.

STATISTICAL ANALYSIS USED

Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA), while paired -test was performed for evaluating the size of tumor and lymph node recorded on clinical and imaging findings. A < 0.05 was considered statistically significant.

RESULTS

Detection of tumor size and lymph node metastasis was found to be higher in case of MRI than when accomplished by clinical staging alone, while paired -test values for difference in results were found to be statistically significant ( < 0.05).

CONCLUSIONS

The present study showed that clinical diagnostic criteria alone were not sufficient and reliable for detecting metastatic lymphadenopathy, highlighting the significance of advanced imaging modalities such as MRI for an efficient preoperative diagnostic workup, as well a tool for planning treatment in patients with OSCCs.

摘要

背景与目的

临床检查中的不准确之处已有充分记录,而包括计算机断层扫描和磁共振成像(MRI)在内的先进成像方式已被证明在检测隐匿性和淋巴结转移方面具有更高的诊断准确性。本研究的目的是借助MRI识别并评估已知口腔鳞状细胞癌(OSCC)病例的临床检查及临床诊断标准中的不准确之处。

材料与方法

本研究共纳入24名门诊患者,对临床诊断并经组织病理学证实的OSCC病例进行临床检查,然后借助MRI进行先进成像。

所用统计分析方法

使用社会科学统计软件包(SPSS)17.0版(美国伊利诺伊州芝加哥市SPSS公司)进行统计分析,采用配对t检验评估临床和影像学检查结果记录的肿瘤及淋巴结大小。P < 0.05被认为具有统计学意义。

结果

发现MRI检测肿瘤大小及淋巴结转移的情况比单纯临床分期更高,且结果差异的配对t检验值具有统计学意义(P < 0.05)。

结论

本研究表明,仅靠临床诊断标准检测转移性淋巴结病变并不充分且不可靠,凸显了MRI等先进成像方式对于高效术前诊断检查以及作为OSCC患者治疗规划工具的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e661/8202445/e9d73418ff9a/JC-20-3-g001.jpg

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