口腔癌主要与次要结外延伸的放射病理相关性。
Radiologic-pathologic correlation of major versus minor extranodal extension in oral cavity cancer.
机构信息
Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
出版信息
Head Neck. 2022 Jun;44(6):1422-1429. doi: 10.1002/hed.27036. Epub 2022 Mar 22.
BACKGROUND
To evaluate the diagnostic performance of radiologic extranodal extension (rENE) in predicting major (>2 mm) and minor (≤2 mm) pathologic ENE (pENE).
METHODS
All oral cavity squamous cell carcinoma patients who underwent neck dissection with pathological nodal disease (pN+) between 2010 and 2015 were reviewed. Preoperative computed tomography and/or magnetic resonance imaging were reviewed by two head and neck neuroradiologists.
RESULTS
Three hundred and thirty-four patients were included. The sensitivity and specificity of rENE were 37% [95% CI 29-44] and 98% [95% CI 96-100], respectively. Sensitivity for pENE improved in the subset of patients with major ENE (48% [95% CI 38-57]). The presence of rENE was associated with inferior 3-year overall survival: 26% [95% CI 17-41] versus 60% [95% CI 54-67].
CONCLUSIONS
This large cohort study demonstrates high specificity, but low sensitivity for preoperative imaging in the detection of pENE in OCSCC. Patients with rENE demonstrated poor OS. pENE in the absence of rENE is still an adverse risk factor.
背景
评估影像学结外延伸（rENE）预测主要（>2mm）和次要（≤2mm）病理性结外侵犯（pENE）的诊断性能。
方法
回顾了 2010 年至 2015 年间所有接受颈清扫术且伴有病理淋巴结疾病（pN+）的口腔鳞状细胞癌患者。由两名头颈部神经放射科医生对术前计算机断层扫描和/或磁共振成像进行了评估。
结果
共纳入 334 例患者。rENE 的敏感性和特异性分别为 37%[95%CI29-44]和 98%[95%CI96-100]。在主要结外侵犯（ENE）患者亚组中，pENE 的敏感性提高（48%[95%CI38-57]）。rENE 的存在与 3 年总生存率降低相关：26%[95%CI17-41]与 60%[95%CI54-67]。
结论
这项大型队列研究表明，术前影像学检查在检测 OCSCC 中的 pENE 方面具有较高的特异性，但敏感性较低。存在 rENE 的患者 OS 较差。即使没有 rENE 的 pENE 仍然是一个不利的风险因素。
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