Stevens M H, Harnsberger H R, Mancuso A A, Davis R K, Johnson L P, Parkin J L
Arch Otolaryngol. 1985 Nov;111(11):735-9. doi: 10.1001/archotol.1985.00800130067007.
Forty patients with head and neck cancer had a computed tomographic (CT) scan followed by lymphadenectomy and pathologic confirmation. The overall accuracy of clinical examination of the neck was 70% vs 93% by CT. The CT correctly "upstaged" the neck in nine patients. One was upstaged from NO to N1, and four each from NO to N2 and N1 to N2. It correctly "downstaged" the neck in one patient (from N2 to N1). Eight patients had extranodal disease on CT confirmed by pathology. The CT findings were correct in ten of 11 previously treated patients. Because CT is more accurate than the clinical examination, it should be included in the staging of not only the primary tumor but also nodal disease of the neck. It can have an important role in the management of head and neck cancer.
40例头颈部癌患者接受了计算机断层扫描（CT），随后进行了淋巴结清扫术及病理确诊。颈部临床检查的总体准确率为70%，而CT的准确率为93%。CT正确地使9例患者的颈部分期“升级”。1例从N0期升至N1期，4例分别从N0期升至N2期以及从N1期升至N2期。它使1例患者的颈部分期“降级”（从N2期降至N1期）。8例患者CT显示的结外病变经病理证实。11例先前接受过治疗的患者中，CT检查结果在10例中是正确的。由于CT比临床检查更准确，它不仅应纳入原发肿瘤的分期，还应纳入颈部淋巴结疾病的分期。它在头颈部癌的治疗中可发挥重要作用。
