Chloupek Aldona, Kania Joanna, Jurkiewicz Dariusz
Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine-National Research Institute, 04-142 Warsaw, Poland.
Department of Pathology, Military Institute of Medicine-National Research Institute, 04-142 Warsaw, Poland.
Diagnostics (Basel). 2023 Jun 28;13(13):2202. doi: 10.3390/diagnostics13132202.
The TNM (tumor, node, metastasis) staging system is important for the successful treatment of head and neck cancers (HNCs). This study aimed to evaluate the concordance between clinical and pathological T and N stages in patients with HNCs in Poland.
In this single-center retrospective study, clinical and pathological TNM staging data on 203 patients undergoing surgical treatment for HNC between 2011 and 2018 were collected and compared. The study group was classified as underdiagnosed, overdiagnosed, or correctly diagnosed with HNC based on pathological TNM staging. The concordance between clinical and pathological staging was evaluated using the kappa coefficient.
Clinical and pathological TNM staging showed concordance in 59.9% of patients for primary tumor (T) and in 79.3% of patients for lymph node (N) classifications. Moderate agreement between the clinical and pathological stages was shown for stage T, while substantial agreement was revealed for stage N. The size and extent of the tumor were underestimated or overestimated in 73 of the 182 patients (40.1%), while lymph node involvement was downstaged in 11 of the 53 patients (20.7%).
The disparities between clinical and pathological staging of HNC demonstrate the need for standardization in physical and pathological examinations, as well as radiographic imaging.
TNM（肿瘤、淋巴结、转移）分期系统对于头颈部癌（HNC）的成功治疗至关重要。本研究旨在评估波兰HNC患者临床和病理T及N分期之间的一致性。
在这项单中心回顾性研究中，收集并比较了2011年至2018年间接受HNC手术治疗的203例患者的临床和病理TNM分期数据。根据病理TNM分期，将研究组分为HNC诊断不足、诊断过度或诊断正确。使用kappa系数评估临床和病理分期之间的一致性。
临床和病理TNM分期在59.9%的原发性肿瘤（T）患者和79.3%的淋巴结（N）分类患者中显示出一致性。T期临床和病理分期之间显示出中等程度的一致性，而N期则显示出高度一致性。182例患者中有73例（40.1%）的肿瘤大小和范围被低估或高估，53例患者中有11例（20.7%）的淋巴结受累情况被降级。
HNC临床和病理分期之间的差异表明，在体格检查、病理检查以及影像学检查方面需要进行标准化。
