Comparison of Intraoperative Sonography and Histopathologic Evaluation of Tumor Thickness and Depth of Invasion in Oral Tongue Cancer: A Pilot Study
Comparison of Intraoperative Sonography and Histopathologic Evaluation of Tumor Thickness and Depth of Invasion in Oral Tongue Cancer: A Pilot Study
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DOI：
10.3174/ajnr.a6625
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发表时间：
2020-07-01
影响因子：
3.5
通讯作者：
Juliano, A. F.
中科院分区：
文献类型：
--
作者：
Yoon, B. C.;Bulbul, M. D.;Juliano, A. F.
背景和目的：对于原发于口腔舌部的鳞状细胞癌，准确评估肿瘤厚度和浸润深度对于分期和手术治疗至关重要。目前，用于术前分期的典型成像模式是CT和MR成像。术中，CT或MR成像无法提供实时指导，手动触诊评估的精度有限。我们研究术中超声检查是否是一种评估肿瘤厚度和浸润深度的可行技术，并通过与切除标本的组织病理学评估进行比较来验证其准确性。材料和方法：2016年3月31日至2019年4月26日期间，26名口腔舌鳞状细胞癌患者接受了由单一外科医生进行的肿瘤切除术，被前瞻性地识别。术中超声检查在肿瘤长轴的纵向和横向平面上进行。22名患者的存档图像，允许测量肿瘤厚度和超声浸润深度。2例患者有发育不良，被排除。其余20例患者的组织学肿瘤厚度和组织学浸润深度由一位病理学家测量。平均超声肿瘤厚度为7.5 ± 3.5 mm，平均组织学肿瘤厚度为7.0 ± 4.2 mm。平均超声浸润深度和组织学浸润深度分别为6.6 ± 3.4 mm和6.4 ± 4.4 mm，分别有很好的相关性之间的超声和组织学测量的肿瘤厚度和深度的浸润与皮尔逊相关系数为0.95（95%CI，0.87-0.98）和0.95（95%CI，0.87-0.98），分别。结论：术中超声检查可以提供可靠的，实时评估舌肿瘤的程度。
BACKGROUND AND PURPOSE: For primary squamous cell carcinoma of the oral tongue, accurate assessment of tumor thickness and depth of invasion is critical for staging and operative management. Currently, typical imaging modalities used for preoperative staging are CT and MR imaging. Intraoperatively, CT or MR imaging cannot provide real-time guidance, and assessment by manual palpation is limited in precision. We investigated whether intraoperative sonography is a feasible technique for assessment of tumor thickness and depth of invasion and validated its accuracy by comparing it with histopathologic evaluation of the resected specimen.MATERIALS AND METHODS: Twenty-six patients with squamous cell carcinoma of the oral tongue who underwent tumor resection by a single surgeon between March 31, 2016, and April 26, 2019, were prospectively identified. Intraoperative sonography was obtained in planes longitudinal and transverse to the long axis of the tumor. Twenty-two patients had archived images that allowed measurements of tumor thickness and depth of invasion sonographically. Two patients had dysplasia and were excluded. The remaining 20 patients had histologic tumor thickness and histologic depth of invasion measured by a single pathologist.RESULTS: The mean sonographic tumor thickness was 7.5 +/- 3.5 mm, and the mean histologic tumor thickness was 7.0 +/- 4.2 mm. Mean sonographic depth of invasion and histologic depth of invasion were 6.6 +/- 3.4 and 6.4 +/- 4.4mm, respectively. There was excellent correlation between sonographic and histologic measurements for both tumor thickness and depth of invasion with Pearson correlation coefficients of 0.95 (95% CI, 0.87-0.98) and 0.95 (95% CI, 0.87-0.98), respectively.CONCLUSIONS: Intraoperative sonography can provide reliable, real-time assessment of the extent of tongue tumors.