Is Ultrasound a Useful Adjunct in the Management of Oral Squamous Cell Carcinoma?
Is Ultrasound a Useful Adjunct in the Management of Oral Squamous Cell Carcinoma?
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DOI：
10.1016/j.joms.2018.08.012
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发表时间：
2019-01-01
影响因子：
1.9
通讯作者：
Dillon, Jasjit
中科院分区：
文献类型：
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作者：
Smiley, Nicholas;Anzai, Yoshimi;Dillon, Jasjit
目的：在口腔鳞状细胞癌（OSCC）患者中，肿瘤浸润深度（DOI）与预后相关。肿瘤厚度 (TT) 通常用作 DOI 的替代测量值。本研究的目的是使用超声检查 (USS)、磁共振成像 (MRI) 和临床评估来估计 OSCC 患者样本中的 TT，并将这些估计值与最终手术标本的 TT 进行比较。 材料和方法：作者设计并实施了一项前瞻性队列研究，并入组了接受 OSCC 治疗的患者。符合条件的受试者患有活检证实的 OSCC，并接受临床评估、MRI 分期和 USS。预测变量是临床评估、USS 或 MRI 的测量技术。主要结果变量是从最终组织病理学标本中获得的最大 TT（厘米）。计算适当的单变量和双变量统计数据。 结果：样本包括 10 名患者（平均年龄，62.7 +/- 13.6 岁；70% 为男性）。 10 个肿瘤中的 2 个 (20%) 未能通过 USS 充分观察到。由于牙伪影，10 个肿瘤中的 3 个 (30%) 未通过 MRI 发现。这 3 名患者的肿瘤通过 USS 进行可视化。 10个肿瘤中的1个（10%）临床上无法触及。 10名患者中的3名（30%）由于肿瘤分期较高或患者的健康状况而没有接受手术，而是接受了放化疗。与标本 TT 测量相比，USS、MRI 和临床 TT 测量值均被低估（分别为 -0.6、-0.5 和 -0.3 cm；P = .9）。结论：与最终手术标本相比，所有 3 种测量方式（临床检查、MRI 和 USS）均低估了 OSCC TT。测量方式之间的平均测量值或绝对值平均差异没有统计学差异。值得注意的是，USS 对 3 名患者 (30%) 的 OSCC 进行了可视化，这些患者的肿瘤可视化效果不佳或 MRI 未可视化。 (C) 2018年美国口腔颌面外科医师协会
Purpose: In patients with oral squamous cell carcinoma (OSCC), depth of tumor invasion (DOI) is correlated with prognosis. Tumor thickness (TT) is often used as a surrogate measurement of DOI. The aim of this study was to estimate TT in a sample of patients with OSCC using ultrasound sonography (USS), magnetic resonance imaging (MRI), and clinical assessment and compare these estimates with TT of the final surgical specimen.Materials and Methods: The authors designed and implemented a prospective cohort study and enrolled patients presenting for management of OSCC. Eligible subjects had biopsy-proved OSCC and received clinical assessment, staging by MRI, and USS. The predictor variable was measurement technique by clinical assessment, USS, or MRI. The primary outcome variable was the maximal TT (centimeters) obtained from the final histopathologic specimen. Appropriate uni- and bivariate statistics were computed.Results: The sample included 10 patients (mean age, 62.7 +/- 13.6 yr; 70% men). Two of the 10 tumors (20%) were not adequately visualized with USS. Three of the 10 tumors (30%) were not seen with MRI because of dental artifact. These 3 patients' tumors were visualized by USS. One of the 10 tumors (10%) could not be palpated clinically. Three of the 10 patients (30%) did not go to surgery and were treated with chemoradiation because of the high tumor stage or the patient's health status. USS, MRI, and clinical TT measurements were underestimates compared with the specimen TT measurement (-0.6, -0.5, and -0.3 cm, respectively; P = .9).Conclusions: All 3 measurement modalities (clinical examination, MRI, and USS) underestimated OSCC TT compared with the final surgical specimen. There were no statistical differences in mean measurement or absolute value mean differences among measurement modalities. Notably, USS visualized the OSCC in the 3 patients (30%) whose tumors were poorly visualized or not visualized with MRI. (C) 2018 American Association of Oral and Maxillofacial Surgeons