PET/CT 与三联内镜在 HPV+口咽鳞状细胞癌初始检查中的比较。

PET/CT versus triple endoscopy in initial workup of HPV+ oropharyngeal squamous cell carcinoma.

机构信息

Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.

Department of Otolaryngology-Head and Neck Surgery, MetroHealth Medical Center, Cleveland, Ohio, USA.

出版信息

Head Neck. 2022 May;44(5):1164-1171. doi: 10.1002/hed.27016. Epub 2022 Feb 25.

DOI:10.1002/hed.27016

PMID:35212072

Abstract

BACKGROUND

Synchronous primary tumors (SPTs) are detected via triple endoscopy or positron emission tomography/computed tomography (PET/CT). Patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV+ OPSCC) lack risk factors for SPTs.

METHODS

We performed a single institution retrospective review of the efficacy of triple endoscopy and PET/CT in HPV+ OPSCC patients.

RESULTS

Sixty-five HPV+ OPSCC patients underwent triple endoscopy and PET/CT. Patients were white (n = 48, 72.7%), male (n = 53, 81.5%), mean 58.7 ± 8.1 years old. SPT was detected in 1 (1.5%) patient via PET/CT. No SPTs were detected on triple endoscopy. PET/CT had 100% and 95.3% sensitivity and specificity, respectively. PET/CT positive predictive value (PPV) and negative predictive value (NPV) were 25.0% and 100%, respectively. Triple endoscopy specificity and NPV was 90.2% and 93.2%, respectively.

CONCLUSIONS

PET/CT is superior to triple endoscopy in ruling out SPTs. With negative PET/CT, only direct laryngoscopy with biopsy may be necessary.

摘要

背景

同步原发性肿瘤（SPTs）可通过三联内镜或正电子发射断层扫描/计算机断层扫描（PET/CT）检测到。人乳头瘤病毒相关口咽鳞状细胞癌（HPV+ OPSCC）患者缺乏 SPT 的风险因素。

方法

我们对 HPV+ OPSCC 患者进行了三联内镜和 PET/CT 的单机构回顾性研究。

结果

65 例 HPV+ OPSCC 患者接受了三联内镜和 PET/CT 检查。患者为白人（n=48，72.7%）、男性（n=53，81.5%），平均年龄 58.7±8.1 岁。1 例（1.5%）患者通过 PET/CT 检测到 SPT。三联内镜未发现 SPT。PET/CT 的灵敏度和特异性分别为 100%和 95.3%。PET/CT 的阳性预测值（PPV）和阴性预测值（NPV）分别为 25.0%和 100%。三联内镜的特异性和 NPV 分别为 90.2%和 93.2%。