Patterns of lymph node metastasis from nasopharyngeal carcinoma based on the 2013 updated consensus guidelines for neck node levels
Patterns of lymph node metastasis from nasopharyngeal carcinoma based on the 2013 updated consensus guidelines for neck node levels
复制标题
DOI：
10.1016/j.radonc.2015.02.017
复制
发表时间：
2015-04-01
影响因子：
5.7
通讯作者：
Ding, JianHui
中科院分区：
文献类型：
--
作者：
Wang, XiaoShen;Hu, ChaoSu;Ding, JianHui
目的：为探讨2013年修订的鼻咽癌颈部淋巴结分级标准对鼻咽癌颈部淋巴结分布的影响，回顾性分析2010年1月至2013年1月3100例新诊断鼻咽癌的影像学资料。所有患者均接受MRI扫描。扫描范围从前床突上方2cm至锁骨胸骨端下缘。结果：2679例（86.4%）有淋巴结转移，其中1000例（26.4%）有淋巴结转移。具体的分布是：等级la 0，等级Ib 115（4.3%），IIa级1 798人（67.1%），IIb级2341人（87.4%），三级1 184（44.2%），IVa级350人（13.1%），四级b 28（1.0%），Va级，B 995（37.1%）、Vc级49（1.8%）、VI级0、Vila级2012（75.1%）、VIIb级178（6.6%）、VIII级53（2.0%）、IX级2、Xa级2、Xb级3。在累及VII节段的患者中，仅6例（0.3%）位于内侧组。在II级病变患者中，25.9%的转移性淋巴结上缘超出Cl尾侧缘。第VIII、IX或X级淋巴结转移的患者总是有广泛的同侧淋巴结肿大，受累淋巴结总数≥ 6个。有35例淋巴结病超出了更新的指南的范围，位于肌内，但后V级结论：这是第一次描述的淋巴结扩散模式的基础上更新的共识指南。咽后淋巴结受累主要位于外侧组，内侧组少见。建议的第二级上边界不能完全覆盖所有涉及的第二级节点。后部V级边界不足以覆盖NPC的所有V级淋巴结病。(C)由Elsevier爱尔兰有限公司出版。
Purpose: To explore patterns of node distribution in nasopharyngeal carcinoma (NPC) based on the 2013 updated guidelines for neck node levels.Methods and materials: We retrospectively reviewed the imaging documents of 3100 cases of newly diagnosed NPC between January 2010 and January 2013. All patients received an MRI scan. The scan range extended from 2 cm above the anterior clinoid process to the inferior margin of the sternal end of the clavicle. All MR images were evaluated by the multi-disciplinary treatment group of NPC.Results: A total of 2679 (86.4%) cases had involved lymph nodes. The detailed distribution was: level la 0, level Ib 115 (4.3%), level IIa 1798 (67.1%), level IIb 2341 (87.4%), level III 1184 (44.2%), level IVa 350 (13.1%), level IVb 28 (1.0%), level Va,b 995 (37.1%), level Vc 49 (1.8%), level VI 0, level Vila 2012 (75.1%), level VIIb 178 (6.6%), level VIII 53 (2.0%), level IX 2, level Xa 2, level Xb 3. Among patients with level VII involvement, only 6(0.3%) were located at the medial group. Of the patients with level II disease, the upper borders of metastatic nodes in 25.9% cases were beyond the caudal edge of Cl. Patients with level VIII, or IX, or X node metastasis were always with extensive ipsilateral lymphadenopathy, and the total number of involved nodes was >= 6. There were 35 cases of lymphadenopathy beyond the range of the updated guidelines, located inside the trapezius muscles, but posterior to level V.Conclusions: This is the first description of nodal spread patterns based on the updated consensus guidelines. Involvement of the retropharyngeal nodes was mainly located at the lateral group, the medial group was rarely seen. The suggested upper border of level II cannot fully cover all the involved level II nodes. The posterior level V border is not enough to cover all level V lymphadenopathies for NPC. (C) 2015 Published by Elsevier Ireland Ltd.