Department of Otolaryngology - Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, WV, USA.
Department of Otolaryngology - Head and Neck Surgery, University of Iowa, Iowa City, IA, USA.
Oral Oncol. 2021 Nov;122:105512. doi: 10.1016/j.oraloncology.2021.105512. Epub 2021 Sep 23.
To investigate the potential utility of intra-oral ultrasound (IOUS) in guiding deep margin clearance and measuring depth of invasion (DOI) of oral tongue carcinomas (OTC).
Retrospective chart review of consecutive patients with T1-T3 OTC who underwent intraoperative ultrasound-guided resection and a comparator group that had undergone resection without the use of IOUS both by a single surgeon. Data was extracted from operative, pathology and radiology reports. Deep margins and DOI were reviewed by a dedicated head and neck pathologist. Correlation between histologic and ultrasound DOI was assessed using Pearson correlation.
A total of 23 patients were included in the study cohort with a comparator group of 21 patients in the control group. None of the patients in the study cohort had a positive (cut-through) deep margin and the mean deep margin clearance was 8.5 ± 4.9 and 6.7 ± 3.8 for the IOUS and non-IOUS groups respectively (p-value 0.18) showing a non-significant improvement in the IOUS group. As a secondary outcome, there was a strong correlation between histologic and ultrasound DOI (0.9449).
Ultrasound appears to be a potentially effective tool in guiding OTC resections. In this small series, IOUS facilitated deep margin clearance and resulted in a non-statistically significant increase in deep margin clearance. Intraoral ultrasound can accurately measure lesional DOI.
研究口腔内超声（IOUS）在引导深层切缘清除和测量口腔舌癌（OTC）侵袭深度（DOI）中的潜在作用。
回顾性分析了由同一位外科医生进行手术的连续 T1-T3 期 OTC 患者中接受术中超声引导切除的病例组和未使用 IOUS 切除的对照组患者的病历。从手术、病理和放射学报告中提取数据。由专门的头颈部病理学家对深层切缘和 DOI 进行复查。使用 Pearson 相关性评估组织学和超声 DOI 之间的相关性。
研究队列共纳入 23 例患者，对照组为 21 例患者。研究队列中无一例患者出现阳性（贯穿）深层切缘，IOUS 组和非 IOUS 组的平均深层切缘清除率分别为 8.5±4.9 和 6.7±3.8（p 值为 0.18），IOUS 组的深层切缘清除率略有改善，但无统计学意义。作为次要结果，组织学和超声 DOI 之间存在很强的相关性（0.9449）。
超声似乎是一种指导 OTC 切除的有效工具。在这项小系列研究中，IOUS 有助于深层切缘的清除，并且在统计学上并未显著增加深层切缘的清除率。口腔内超声可以准确测量病变的 DOI。
