Ning Yu Dong, Song Yi Xuan, He Yu Qin, Li Han, Liu Shao Yan
Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
These authors contributed equally to this study.
World J Oncol. 2025 Feb;16(1):59-69. doi: 10.14740/wjon1973. Epub 2024 Dec 31.
We here investigated the value of imaging examination in evaluating tumor remission-based surgery in patients with head and neck squamous cell carcinoma (HNSCC), who had undergone neoadjuvant immunotherapy combined with chemotherapy (NICC).
HNSCC patients who underwent NICC and surgery from May 2021 to September 2023 were retrospectively analyzed. All patients had to undergo imaging examination evaluation, including enhanced computed tomography (CT) and enhanced magnetic resonance (MR) imaging before and after NICC. Data related to clinical parameters, complete response of the primary site (PrCR), complete response of the primary site and the lymph node (PLCR), complete response of the lymph node (LCR), and tumor response (TR), were gathered. The paired Chi-square test and -test were conducted to analyze the differences in responses between imaging examination and pathology. Binary logistic regression was applied to analyze the relevant clinical factors of differences in responses.
In total, data of 41 patients were included in this study. Significant discordant responses were observed between enhanced CT, magnetic resonance imaging (MRI), and pathology in PrCR (4.9%, 7.3% vs. 41.5%), LCR (12.2%, 7.3% vs. 53.7%), PLCR (0%, 0% vs. 31.7%), and TR (severe 29.3%,17.1% vs. 25.61%) (P < 0.05). Patients with hypopharyngeal cancer (odds ratio (OR): 7.04), oral cancer (OR: 3.64), higher neutrophil to lymphocyte ratio (NLR) (OR: 2.05), and earlier T stage (OR: 0.71) exhibited a larger response difference between enhanced CT and pathology. Patients with younger age (OR: 0.79) hypopharyngeal cancer (OR: 22.81), oral cancer (OR: 2.65), higher NLR (OR: 19.47), and earlier T stage (OR: 0.29) exhibited a larger response difference between enhanced MR and pathology.
Discordant responses were noted between the imaging examination and surgical pathology of HNSCC after NICC. Hypopharyngeal cancer, higher NLR, and earlier T stage may predict a higher response difference.
我们在此研究了影像学检查在评估接受新辅助免疫治疗联合化疗（NICC）的头颈部鳞状细胞癌（HNSCC）患者基于肿瘤缓解的手术中的价值。
回顾性分析2021年5月至2023年9月期间接受NICC和手术的HNSCC患者。所有患者均需接受影像学检查评估，包括NICC前后的增强计算机断层扫描（CT）和增强磁共振（MR）成像。收集与临床参数、原发部位完全缓解（PrCR）、原发部位和淋巴结完全缓解（PLCR）、淋巴结完全缓解（LCR）以及肿瘤反应（TR）相关的数据。进行配对卡方检验和t检验以分析影像学检查与病理反应之间的差异。应用二元逻辑回归分析反应差异的相关临床因素。
本研究共纳入41例患者的数据。在PrCR（4.9%、7.3%对41.5%）、LCR（12.2%、7.3%对53.7%）、PLCR（0%、0%对31.7%）和TR（重度29.3%、17.1%对25.61%）方面，增强CT、磁共振成像（MRI）与病理之间观察到显著的不一致反应（P<0.05）。下咽癌患者（比值比（OR）：7.04）、口腔癌患者（OR：3.64）、中性粒细胞与淋巴细胞比值（NLR）较高（OR：2.05）以及T分期较早（OR：0.71）的患者在增强CT与病理之间表现出更大的反应差异。年龄较小（OR：0.79）的下咽癌患者（OR：22.81）、口腔癌患者（OR：2.65）、NLR较高（OR：19.47）以及T分期较早（OR：0.29）的患者在增强MR与病理之间表现出更大的反应差异。
NICC后HNSCC的影像学检查与手术病理之间存在不一致反应。下咽癌、较高的NLR和较早的T分期可能预示着更高的反应差异。
