CT 用于评估头颈部鳞状细胞癌患者淋巴结清扫的充分性。

CT for estimating adequacy of lymph node dissection in patients with squamous cell carcinoma of the head and neck.

机构信息

Geisel School of Medicine at Dartmouth, Hanover, NH, USA.

Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

出版信息

Cancer Imaging. 2021 Nov 21;21(1):61. doi: 10.1186/s40644-021-00430-6.

DOI:10.1186/s40644-021-00430-6

PMID:34802462

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8607725/

Abstract

BACKGROUND

Indices obtained from lymph node dissection specimens, specifically lymph node yield (LNY) and lymph node ratio (LNR), have prognostic significance in the setting of head and neck squamous cell carcinoma (HNSCCa). However, there are currently no validated tools to estimate adequacy of planned lymph node dissection using preoperative data. The present study sought to evaluate CT-derived estimates of lymphatic tissue volumes as a preoperative tool to guide cervical node dissection.

METHODS

Fifteen cervical lymph node dissections were performed in 14 subjects with HNSCCa. Preoperative CT-derived estimates of lymphatic tissue volumes were compared with gross pathology tissue volume estimates and pathologically-determined LNY.

RESULTS

Resected tissue volume (calculated using the triaxial ellipsoid method) correlates with CT-derived preoperative lymphatic volume estimates (r = 0.74, p = 0.003) while LNY does not(r = - 0.12, p = 0.67). When excluding pathologically enlarged lymph nodes ("refined" data), a negative correlation was observed between refined CT-derived volume estimates and refined LNY (r = - 0.65, p = 0.009).

CONCLUSION

In the setting of cervical lymph node dissection, CT-derived lymphatic volume estimates correlate with resected tissue volume, but refined CT-derived volume estimates correlate negatively with refined LNY.

TRIAL REGISTRATION

Retrospectively registered.

LEVEL OF EVIDENCE

摘要

背景

从淋巴结清扫标本中获得的指标，特别是淋巴结产量（LNY）和淋巴结比率（LNR），对头颈部鳞状细胞癌（HNSCCa）的预后具有重要意义。然而，目前尚无经验证的工具可以使用术前数据来估计计划的淋巴结清扫的充分性。本研究旨在评估 CT 衍生的淋巴组织体积估计值作为指导颈部淋巴结清扫的术前工具。

方法

对 14 名患有 HNSCCa 的患者进行了 15 次颈部淋巴结清扫术。将术前 CT 衍生的淋巴组织体积估计值与大体病理组织体积估计值和病理确定的 LNY 进行比较。

结果

切除组织体积（使用三轴椭圆体法计算）与 CT 衍生的术前淋巴体积估计值相关（r = 0.74，p = 0.003），而 LNY 不相关（r = -0.12，p = 0.67）。当排除病理性增大的淋巴结（“精制”数据）时，精制 CT 衍生的体积估计值与精制 LNY 之间观察到负相关（r = -0.65，p = 0.009）。