Establishment of the sonogiaphic scanning techniques and diagnostic criteria of intraoral sonography for tongue squamous cell carcinoma

我们报道了正常舌黏膜的三层结构，即1)表面层，2)粘膜层，3)粘膜下层和肌肉层，并讨论了三层结构的超声特征对舌鳞状细胞癌肿瘤侵袭的临床意义。2006年，我们研究了舌表面鳞状细胞癌在口腔内超声检查中的特征性表现。8名患者被纳入研究。术前使用小型HST探针进行检查。为了获得最佳的肿瘤测量结果，我们还使用了厚度为3 mm或10 mm的声学偶联聚合物凝胶，并将超声结果与组织病理学结果进行了并排比较。在超声检查上，每个病人的浅表性癌都被清楚地解释为粘膜层增厚。此外，在增厚的粘膜层下，可见模糊的低回声区。组织病理学上，低回声区可见炎性细胞浸润。在某些情况下，功率多普勒成像在增厚的粘膜层底部观察到血流信号。2007年，我们尝试建立舌鳞状细胞癌浸润深度（肿瘤厚度）的诊断标准，用于预测后续淋巴结转移。20名患者被纳入研究。我们的结论是5mm是预测后续淋巴结转移的最合适的临界值。如果认为原发肿瘤厚度超过5mm为阳性淋巴结，则后续淋巴结转移的敏感性为82%，特异性为78%，准确性为80%。此外，我们推测增厚的粘膜层底部的血流信号可能是提示浅表性癌的特殊表现之一。少

We have been reported the three-layer structure of normal tongue mucosa, i.e., 1) surface layer, 2) mucosal layer, 3) submucosal layer and muscle layers, demonstrated on intraoral sonography and discussed the clinical significance of the sonographic feature of the three-layer structure for evaluation of tumor invasion of the squamous cell carcinoma of the tongue.In 2006, we investigated the characteristic findings of the superficial squamous cell carcinoma of the tongue demonstrated on intraoral sonography. Eight patients were included in the study. Preoperative examination was performed using small HST probes. We also used an acoustic coupling polymer gel with a thickness of 3 mm or 10 mm in order to obtain the optimal measurement of the tumor A side-by-side comparison was performed between the sonographic findings and the histopathological findings. On sonography, superficial carcinoma was clearly interpreted as a thickened mucosal layer in every patient. Additionally, an ill-defined … More hypoechoic area was also observed under the thickened mucosal layer. Histopathologically, inflammatory cellular infiltration was observed corresponding to the hypoechoic area. In some instances, the blood flow signal was observed at the bottom of the thickened mucosal layer on power Doppler imaging.In 2007, we tried to establish the diagnostic criteria of the depth of invasion (tumor thickness) of the tongue squamous cell carcinoma for the prediction of subsequent lymph node metastases. Twenty patients were included in the study. We concluded that 5 mm was the most appropriate cut-off for predicting subsequent lymph node metastases. If it is considered that a primary tumor thickness exceeding 5 mm indicates positive nodes, the sensitivity, specificity and accuracy for subsequent lymph node metastasis was 82, 78 and 80% respectively. Also, we speculated that blood flow signal at the bottom of the thickened mucosal layer might be one of the peculiar findings suggesting superficial carcinoma. Less