Don D M, Anzai Y, Lufkin R B, Fu Y S, Calcaterra T C
Department of Surgery, University of California Los Angeles Medical Center 90024, USA.
Laryngoscope. 1995 Jul;105(7 Pt 1):669-74. doi: 10.1288/00005537-199507000-00001.
Although computed tomography and magnetic resonance imaging have contributed to the ability to identify metastatic disease in head and neck cancer, inadequacies in evaluating lymphadenopathy still exist. This study was undertaken to estimate the accuracy of radiological criteria used to detect cervical lymph node metastases. The morphological characteristics of 957 lymph nodes from 36 neck dissections from patients with squamous cell cancer were examined microscopically. A large number of malignant nodes were found to have diameters of less than 10 mm. Extranodal spread also occurred in a substantial percentage of smaller nodes. Because the present radiological criteria for assessing cervical lymph node status are based largely on size, findings indicate major limitations in the capabilities of detecting metastatic disease. New modalities to improve the staging of head and neck cancer are discussed.
尽管计算机断层扫描和磁共振成像有助于识别头颈癌中的转移性疾病，但在评估淋巴结病方面仍存在不足。本研究旨在评估用于检测颈部淋巴结转移的放射学标准的准确性。对36例鳞状细胞癌患者颈部清扫术中957个淋巴结的形态特征进行了显微镜检查。发现大量恶性淋巴结直径小于10毫米。相当比例的较小淋巴结也发生了结外扩散。由于目前评估颈部淋巴结状态的放射学标准主要基于大小，研究结果表明在检测转移性疾病的能力方面存在重大局限性。讨论了改善头颈癌分期的新方法。
