Department of Nuclear Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
J Cancer Res Ther. 2022 Jul-Sep;18(4):1045-1051. doi: 10.4103/jcrt.jcrt_2294_21.
This study aimed to investigate the contribution of metabolic positron emission tomography/computed tomography (PET/CT) parameters of the primary tumor in predicting regional lymph node metastasis (LNM) at initial staging in patients with head and neck squamous cell carcinoma (HNSCC).
A total of 114 patients diagnosed with HNSCC and who underwent PET/CT scanning for staging were included in the study between May 2014 and December 2020. Predictive values of maximum standardized uptake value (SUVmax), maximum standardized uptake ratio (SURmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor in the prediction of cervical LNM were evaluated with logistic regression.
The patients were diagnosed with cancer of the larynx (46.5%), oropharynx (9.6%), nasopharynx (22.8%), hypopharynx (4.4%), and oral cavity (16.7%). All metabolic parameters of the primary tumor were significantly different between patients with positive and negative LNM (all P < 0.001). MTV (P = 0.022) and TLG (P = 0.007) were significantly higher in patients with contralateral LNM. MTV value of the primary tumor was found as the single significant predictor of regional LNM in patients with HNSCC (OR = 23.17, P < 0.001 vs. OR = 31.1, P < 0.001, respectively) in univariate and multivariate logistic regression analyses. The sensitivity, specificity, and accuracy of MTV were 89%, 80%, and 86%, respectively.
MTV of the primary tumor can predict regional LNM and guide the selection of the treatment modalities and clinical decisions in patients with HNSCC at initial staging.
本研究旨在探讨原发肿瘤代谢正电子发射断层扫描/计算机断层扫描（PET/CT）参数在预测头颈部鳞状细胞癌（HNSCC）初始分期区域淋巴结转移（LNM）中的作用。
2014 年 5 月至 2020 年 12 月，共纳入 114 例经 PET/CT 扫描分期诊断为 HNSCC 的患者。采用逻辑回归评估原发肿瘤最大标准化摄取值（SUVmax）、最大标准化摄取比值（SURmax）、代谢肿瘤体积（MTV）和总肿瘤糖酵解（TLG）对预测颈淋巴结转移的预测值。
患者被诊断为喉癌（46.5%）、口咽癌（9.6%）、鼻咽癌（22.8%）、下咽癌（4.4%）和口腔癌（16.7%）。原发肿瘤的所有代谢参数在 LNM 阳性和阴性患者之间均有显著差异（均 P<0.001）。双侧 LNM 患者的 MTV（P=0.022）和 TLG（P=0.007）均显著升高。在单因素和多因素逻辑回归分析中，原发肿瘤 MTV 值被发现是 HNSCC 患者区域 LNM 的唯一显著预测因子（OR=23.17，P<0.001 vs. OR=31.1，P<0.001）。MTV 的灵敏度、特异度和准确度分别为 89%、80%和 86%。
原发肿瘤 MTV 可预测区域 LNM，指导 HNSCC 初始分期患者的治疗方式选择和临床决策。
