The role of ultrasound in the detection of cervical lymph node metastases in clinically N0 squamous cell carcinoma of the head and neck.
The role of ultrasound in the detection of cervical lymph node metastases in clinically N0 squamous cell carcinoma of the head and neck.
复制标题
超声检查在颈部淋巴结转移中的作用在头部和颈部临床N0鳞状细胞癌中的作用。
DOI：
10.1102/1470-7330.2007.0024
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发表时间：
2007-11-19
期刊：
影响因子：
4.9
通讯作者：
Peacock, T E
中科院分区：
文献类型：
--
作者：
Richards, P S;Peacock, T E
结节受累是影响头颈部鳞状细胞癌(HNSCC)预后的最重要因素。单侧或对侧转移结节的存在使存活率降低50%，双侧病变进一步减少50%。N+HNSCC的管理比较明确。相比之下，临床N0病患者的调查和治疗是有争议的。大多数机构选择通过手术或放射治疗来治疗颈部，因为隐性转移的风险超过20%，尽管在大多数情况下没有必要。在这种情况下，转移的主要目的将是评估那些不会被删除的节点。然而，临床上N0颈的最佳处理仍然存在争议，人们对更保守的方法越来越感兴趣。现在的研究方向是找到一种足够敏感的分期方法，将隐匿性转移的风险降低到20%以下。高空间分辨率、易于多平面扫描、能量多普勒以及进行细胞学引导细针抽吸的能力使超声(US)比其他成像技术更具优势。
Nodal involvement is the most important prognostic factor in head and neck squamous cell carcinoma (HNSCC) of mucosal origin. The presence of a single ipsilateral or contralateral metastatic node reduces survival by 50% and bilateral disease by a further 50%. The management of N+ HNSCC is relatively clear-cut. By contrast, the investigation and treatment of patients with clinically N0 disease is controversial. Most institutions electively treat the neck with surgery or radiotherapy because the risk of occult metastases is over 20%, even though it will be unnecessary in the majority of cases. In this situation the main purpose of staging would be to assess those nodes that are not going to be removed. However, the optimal management of the clinically N0 neck remains controversial and there is growing interest in a more conservative approach. Research is now directed toward finding a method of staging sensitive enough to bring the risk of occult metastases below 20%. High spatial resolution, ease of multiplanar scanning, power Doppler and the ability to perform guided fine-needle aspiration for cytology give ultrasound (US) an advantage over other imaging techniques.