增强CT对口腔原发鳞癌颈部淋巴结转移的诊断价值

Diagnostic value of enhanced CT for cervical lymph node metastases of primary oral squamous cell carcinoma

目的探讨增强CT对原发性口腔鳞癌在颈部各区以及不同位置肿瘤中淋巴结转移的诊断价值。方法回顾性分析127例行原发灶切除及颈部淋巴结清扫的口腔鳞癌患者资料,将病理结果与增强CT检查结果进行对比,对CT定性诊断淋巴结转移及淋巴结分区转移的敏感性、特异性、假阳性率(NPV)、真阳性率(PPV)进行评价。结果增强CT诊断口腔癌Ⅰ~Ⅱ区组和Ⅲ~Ⅳ区组淋巴结转移的敏感性分别为79.7%和42.3%,NPV分别为83.3%和67.2%。对比不同位置口腔癌淋巴结转移CT诊断准确率结果显示,舌癌淋巴结转移的诊断敏感性最高(84.5%),口底癌淋巴结转移敏感性最低(53.7%);颊癌淋巴结转移的诊断特异性最低。结论增强CT诊断口腔癌颈部淋巴结转移的敏感性及特异性均较高,但对颈部不同分区、不同位置肿瘤淋巴结转移的诊断准确率有差异。

Objective To explore the diagnostic value of enhanced CT for lymph node metastasis in neck and other locations in case of primary oral squamous cell carcinoma. Methods Retrospective analysis was performed on 127 patients who received primary resection and cervical lymph node dissection due to oral squamous cell carcinoma, pathologic findings and enhanced CT examination results were compared, sensitivity, specificity, negative predictive value(NPV), and positive predictive value(PPV) were evaluated for qualitative CT diagnosis of lymph node metastasis and each nodal level. Results According to enhanced CT diagnosis result, the sensitivities of lymph node metastasis of level Ⅰ-Ⅱ group and level Ⅲ-Ⅳ group were 79.7% and 42.3% respectively, and NPV was83.3% and 67.2% respectively. By comparing the CT diagnosis precision rate of lymph node metastasis in case of oral carcinoma in various locations, we found that lymph node metastasis in tongue cancer peaked the diagnostic sensitivity by 84.5%, and the oral floor carcinoma was at the nadir(53.7%);lymph node metastasis of buccal cancer had the lowest diagnostic specificity. Conclusion Enhanced CT enjoys a high diagnostic sensitivity and specificity in the case of cervical lymph node metastasis of oral carcinoma, with a diagnostic precision rate varying with levels and locations.