Hou Z X, Lyu Z H, Xu W
Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan 250022, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Apr 7;57(4):467-473. doi: 10.3760/cma.j.cn115330-20210525-00296.
To compare the clinical features and prognoses of patients with oropharyngeal or hypopharyngeal squamous cell carcinoma (SCC) with and without retropharyngeal lymph node metastases. PubMed, Cochrane, Web of Science, CNKI, VIP and Wanfang databases were searched for published literatures on retropharyngeal lymph node metastasis of oropharyngeal or hypopharyngeal squamous cell carcinoma (1900, 2021), and outcome indicators such as survival rate and related clinical features were extracted. The quality evaluation of the included literatures was carried out. RevMan 5.4 and Stata 16.0 software were used for data analysis. A total of 18 literatures were included. Meta analysis showed that 3-year and 5-year survival rates and 5-year disease-specific survival rate of patients with oropharyngeal or hypopharyngeal squamous cell carcinoma with retropharyngeal lymph node metastases were lower than those without metastases, 46.1% 53.0%, 40.8% 62.5% and 35.9% 53.1%, respectively, and the differences were statistically significant ( values were 0.26, 0.38, 0.38, and 95% were 0.10-0.69, 0.28-0.51, 0.23-0.65, respectively, all values<0.05). There were statistically significant differences in clinical stage (III-IV), T stage (T3+T4), N stage (N2), positive cervical lymph node metastases and number of lymph node metastases (≥3) between the two groups ( values were 4.28, 2.20, 2.88, 10.83, 6.53, and 95% were 1.70-10.74, 1.35-3.58, 1.90-4.34, 3.57-32.95, 1.75-24.38, respectively, all <0.05). The sensitivity and specificity of preoperative imaging for diagnosing retropharyngeal lymph nodes metastases were respectively 0.72 (95%=0.54-0.85) and 0.98 (95%=0.74-1.00), and the area under curve (AUC) of summary receiver operating characteristic curve (SROC) was 0.84 (95%=0.80-0.87). The survival rate of patients with oropharyngeal or hypopharyngeal squamous cell carcinoma with retropharyngeal lymph node metastasis is significantly reduced, the clinical stage and T stage are late, and the cervical lymph node metastasis rate is high. Retropharyngeal lymph node metastasis is more insidious, the sensitivity of preoperative imaging diagnosis is not high.
比较有或无咽后淋巴结转移的口咽或下咽鳞状细胞癌(SCC)患者的临床特征和预后。检索PubMed、Cochrane、Web of Science、CNKI、VIP和万方数据库中关于口咽或下咽鳞状细胞癌咽后淋巴结转移的已发表文献(1900年至2021年),提取生存率等结局指标及相关临床特征。对纳入文献进行质量评估。使用RevMan 5.4和Stata 16.0软件进行数据分析。共纳入18篇文献。Meta分析显示,有咽后淋巴结转移的口咽或下咽鳞状细胞癌患者的3年和5年生存率以及5年疾病特异性生存率低于无转移者,分别为46.1%对53.0%、40.8%对62.5%和35.9%对53.1%,差异有统计学意义( 值分别为0.26、0.38、0.38,95% 为0.10 - 0.69、0.28 - 0.51、0.23 - 0.65,所有 值<0.05)。两组在临床分期(III - IV期)、T分期(T3 + T4)、N分期(N2)、颈部阳性淋巴结转移及淋巴结转移数量(≥3个)方面差异有统计学意义( 值分别为4.28、2.20、2.88、10.83、6.53,95% 为1.70 - 10.74、1.35 - 3.58、1.90 - 4.34、3.57 - 32.95、1.75 - 24.38,均<0.05)。术前影像学诊断咽后淋巴结转移的敏感度和特异度分别为0.72(95% = 0.54 - 0.85)和0.98(95% = 0.74 - 1.00),汇总受试者工作特征曲线(SROC)的曲线下面积(AUC)为0.84(95% = 0.80 - 0.87)。有咽后淋巴结转移的口咽或下咽鳞状细胞癌患者生存率显著降低,临床分期和T分期较晚,颈部淋巴结转移率高。咽后淋巴结转移更隐匿,术前影像学诊断敏感度不高。