Neal Timothy W, Wahidi Jason, Williams Fayette C, Schlieve Thomas, Donepudi Jyotsna, Kim Roderick Y
Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern/Parkland Memorial Hospital, Dallas, Texas, USA.
Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Hospital Health Network, Fort Worth, Texas, USA.
Proc (Bayl Univ Med Cent). 2024 Jan 29;37(3):396-400. doi: 10.1080/08998280.2024.2308477. eCollection 2024.
The degree of bone involvement in mandibular squamous cell carcinoma has a significant impact on surgical planning. The purpose of this study was to determine the utility of cone-beam computed tomography (CBCT) for the evaluation of invasion by mandibular squamous cell carcinoma.
A retrospective review was conducted to identify subjects treated for oral squamous cell carcinoma (OSCC). All subjects had OSCC adjacent or fixed to the mandible, received preoperative CBCT and multislice computed tomography scan (MSCT), and had resection specimens that included bone.
Twenty-one subjects met the inclusion criteria. The sensitivity of CBCT was 100% (95% CI 0.75-1), the specificity was 75% (95% CI 0.35-0.97), the positive predictive value was 87% (95% CI 0.66-0.98), and the calculated test accuracy was 91%. The sensitivity of MSCT was 92% (95% CI 0.64-1), the specificity was 100% (95% CI 0.63-1), and the calculated test accuracy was 95%.
CBCT provides meaningful data that may be useful in identifying bony involvement in patients with mandibular squamous cell carcinoma. The utility in delineating erosion versus invasion is limited.
下颌鳞状细胞癌的骨受累程度对手术规划有重大影响。本研究的目的是确定锥形束计算机断层扫描（CBCT）在评估下颌鳞状细胞癌侵袭方面的效用。
进行回顾性研究以确定接受口腔鳞状细胞癌（OSCC）治疗的受试者。所有受试者的OSCC均邻近或固定于下颌骨，接受了术前CBCT和多层计算机断层扫描（MSCT），且切除标本包含骨组织。
21名受试者符合纳入标准。CBCT的敏感性为100%（95%可信区间0.75 - 1），特异性为75%（95%可信区间0.35 - 0.97），阳性预测值为87%（95%可信区间0.66 - 0.98），计算得出的检测准确率为91%。MSCT的敏感性为92%（95%可信区间0.64 - 1），特异性为100%（95%可信区间0.63 - 1），计算得出的检测准确率为95%。
CBCT提供了有意义的数据，可能有助于识别下颌鳞状细胞癌患者的骨受累情况。在区分骨侵蚀与骨侵袭方面的效用有限。
