Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
Attending Doctor, Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 May;133(5):582-592. doi: 10.1016/j.oooo.2021.10.024. Epub 2021 Nov 7.
The objective of this study was to investigate the correlation between magnetic resonance imaging (MRI) characteristics of cervical lymph nodes and the pathologically confirmed status of cervical lymph node metastasis (LNM) in oral squamous cell carcinoma (OSCC) and to provide imaging evaluation parameters for the clinical diagnosis of cervical lymph node status in OSCC.
In a retrospective analysis, 79 patients who were first pathologically diagnosed with OSCC were included. The MRI-derived imaging parameters of the cervical lymph nodes were evaluated and the pathological status of lymph nodes in neck dissection specimens was reviewed. The relationship between the imaging parameters and cervical LNM was analyzed.
The MRI-derived imaging parameters of 4419 lymph nodes were evaluated, and the pathological status of 2463 lymph nodes was reviewed. The MRI-derived shortest axial diameter (SAD) and unclear boundary of the cervical lymph node were significantly related to LNM. The cutoff value of SAD that enabled identification of LNM was 3.6 mm, and it was 4.2 and 4.1 mm for the prediction of overall survival and disease-specific survival, respectively.
The MRI-derived parameters SAD and unclear boundary of the cervical lymph node correlated with LNM in OSCC. MRI-derived SAD larger than 3 mm warrants simultaneous neck dissection at initial surgery.
本研究旨在探讨口腔鳞状细胞癌（OSCC）颈部淋巴结磁共振成像（MRI）特征与病理证实的颈部淋巴结转移（LNM）状态之间的相关性，并为 OSCC 颈部淋巴结状态的临床诊断提供影像学评估参数。
在回顾性分析中，纳入了 79 例首次病理诊断为 OSCC 的患者。评估了颈部淋巴结的 MRI 衍生成像参数，并回顾了颈部淋巴结清扫标本的病理状态。分析了成像参数与颈部 LNM 的关系。
评估了 4419 个淋巴结的 MRI 衍生成像参数，并回顾了 2463 个淋巴结的病理状态。颈部淋巴结的最短轴向直径（SAD）和边界不清晰与 LNM 显著相关。SAD 的截断值为 3.6mm，可用于识别 LNM，其用于预测总生存和疾病特异性生存的截断值分别为 4.2mm 和 4.1mm。
OSCC 中，MRI 衍生的 SAD 和颈部淋巴结边界不清晰参数与 LNM 相关。MRI 衍生的 SAD 大于 3mm 时，在初始手术时应同时进行颈部淋巴结清扫。
