Evaluation of Metastatic Lymph Nodes in Oral Squamous Cell Carcinoma: A Comparative Study of Clinical, FNAC, Ultra Sonography and Computed Tomography with Post Operative Histopathology.

All the head and neck tumours, more than 90% are squamous cell carcinomas (SCC). The presence of metastatic cervical lymph nodes histologically positive for SCC provides one of the simplest and most important prognostic factor in patients with head and neck cancer. In this study, all patients were examined clinically for, location, number, size, shape, consistency and fixation of cervical neck nodes to the underlying structure, and the same was carried out by FNAC, USG and CT. Findings of these modalities and histopathological results were compared for the overall metastases of lymph nodes in the neck. The accuracy of clinical examination was 87.77% and sensitivity only 41.66%. FNAC has the greatest specificity, 98.71% and least sensitivity, 33.33%. The accuracy of FNAC was 90%. The positive predictive value and negative predictive value of FNAC were 80.0% and 90.58% respectively. USG revealed 50% of sensitivity. Specificity of USG was 93.58% and accuracy 87.77%. CT scan have the highest sensitivity among all other tests, 66.66%.The negative predictive value for CT scan was also the highest, 94.59%. Specificity and accuracy of CT scan was 89.74% and 86.66% respectively. This study concludes that USG with FNAC is the most accurate in evaluating metastatic lymph nodes in oral squamous cell carcinoma patients along with other investigations like CT scan for staging of the oral squamous cell carcinoma.