Kottakota Viswanth, Sarkar Dibya Falgoon, Tadepalli V N Saratchandu, Yadaraju Vijaya Aditya, Muralidhar Kalla B, Kotne Sanketh, Bora Muralidhar, Lagudu Perraju Bhaskar Bhuvan
Department of Surgical Oncology, HCG Cancer Centre, APIIC Health City, Arilova, Visakhapatnam, Andhra Pradesh 530040 India.
Department of Radiation Oncology, HCG Cancer Centre, APIIC Health City, Arilova, Visakhapatnam, Andhra Pradesh 530040 India.
J Maxillofac Oral Surg. 2024 Aug;23(4):856-863. doi: 10.1007/s12663-024-02265-7. Epub 2024 Jun 19.
The primary aim is to determine the accuracy of contrast-enhanced computed tomography (CT) in evaluation of depth of invasion (DOI) and detection of cervical node metastasis. We also analysed the relation between radiographic DOI (rDOI) and cervical lymph node metastasis.
We have retrospectively reviewed 201 oral squamous cell carcinoma (SCC) patients. The rDOI was compared with histological DOI. Sensitivity, specificity, accuracy, and negative (NPV) and positive (PPV) predictive values were evaluated for CT scan in predicting nodal metastasis. The relation between rDOI and lymph node metastasis was analysed using ROC curve.
rDOI correlated significantly with histologic DOI for oral tongue, buccal mucosa, gingiva, and mucosal lip SCC ( < 0.05) and for tumours with rDOI > 5 mm. The sensitivity, specificity, PPV, NPV and accuracy rate of CT scan were found to be 84.71%, 50.86%, 55.81%, 81.94% and 65.17%, respectively. Tumours with rDOI > 16 mm had significant ( < 0.001) chance of having neck node metastasis.
CT-derived DOI correlates significantly with pathological DOI although both are not similar. CT scan can predict nodal metastasis in fairly accurate manner using the four radiographic criteria used in this study. Radiographic depth of invasion can be used as predictor of cervical node metastasis.
主要目的是确定对比增强计算机断层扫描（CT）在评估浸润深度（DOI）和检测颈部淋巴结转移方面的准确性。我们还分析了影像学DOI（rDOI）与颈部淋巴结转移之间的关系。
我们回顾性分析了201例口腔鳞状细胞癌（SCC）患者。将rDOI与组织学DOI进行比较。评估CT扫描预测淋巴结转移的敏感性、特异性、准确性以及阴性（NPV）和阳性（PPV）预测值。使用ROC曲线分析rDOI与淋巴结转移之间的关系。
对于舌腹、颊黏膜、牙龈和唇黏膜SCC，以及rDOI>5 mm的肿瘤，rDOI与组织学DOI显著相关（<0.05）。CT扫描的敏感性、特异性、PPV、NPV和准确率分别为84.71%、50.86%、55.81%、81.94%和65.17%。rDOI>16 mm的肿瘤发生颈部淋巴结转移的可能性显著（<0.001）。
虽然CT得出的DOI与病理DOI并不相似，但二者显著相关。使用本研究中采用的四项影像学标准，CT扫描能够以相当准确的方式预测淋巴结转移。影像学浸润深度可作为颈部淋巴结转移的预测指标。
