Comparison of pre-operative ultrasonic depth of invasion (DOI) with histopathological depth of invasion (DOI) in gingivobuccal sulcus squamous cell carcinoma with neck nodal metastasis.

IF 2.2 3区 医学 Q2 OTORHINOLARYNGOLOGY
Akshay A Byadgi, Venkatesh Anehosur, Kaveri Hallikeri, Niranjan Kumar
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引用次数: 0

Abstract

Introduction: Head and neck carcinomas have the highest incidence among other carcinomas in the several regions of the country with trends still rising in the third population. The tumor mass is not planar but rather grows three-dimensionally, so surgeons should have the knowledge of the third dimension, which is the depth of invasion (DOI). Nowadays advanced techniques have been introduced to measure the preoperative depth of invasion of the primary tumor, i.e., ultrasonography (USG) scans. Ultrasonography (USG) scan is still considered a preoperative gold standard to measure DOI because of its advantages of radiation-free imaging and excellent tumor visualization, economical, non-invasive, and real-time images that can be obtained spontaneously. The primary objective of the study was to evaluate and compare pre-operative ultrasonic depth of invasion (DOI) with histopathological DOI in gingivobuccal sulcus squamous cell carcinoma with neck nodal metastasis.

Materials and methodology: This is a single-center prospective study including 51 patients reporting to our unit from November 2019 to November 2021 who were subjected to surgery. Preoperative USG evaluation of lesion was performed on all patients which recorded DOI.Similarly, postoperatively, all the resected specimens were examined for the histopathological DOI.The value obtained preoperatively from USG examinations was then compared with histopathological DOI postoperatively. Correlation coefficient analysis was studied using a scatter diagram by Karl Pearson and a dependent t-pair test. A chi-square with Yates's correction test was used to study the statistical association between USG DOI and lymph node metastasis (LNM).

Results: A total of 51 patients were included in the study of which 40(78.4%) were male patients and 11(21.6%) were female patients. DOI measured preoperatively from the USG scan in these cases ranged from 6 mm to 37 mm with an average of 19.41 mm. Histopathological DOI measured in all these patients ranged from 1.3 mm to 16 mm with an average of 7.26 mm. A statistical significance was noted between preoperatively measured DOI from the USG scan and postoperatively (histologically) measured DOI with a p-value of 0.0316. Cervical lymph node metastasis was USG positive in 15 (29.41%) patients out of 51 patients. Chi-square test with Yates's correction = 0.2721, P = 0.6020, noted association between the USG DOI and the occurrence of the cervical lymph node metastasis.

Conclusion: DOI is clearly a potentially useful and objectively measurable prognostic tool. USG imaging studies are used preoperatively to locate the extension of the lesion proper and to measure the area of the deepest invasion of the tumour. Preoperatively, DOI data obtained helps the surgeon to plan 3-dimensional clearance of the disease. Although USG scans lack in early detection of bone invasion in gingivo buccal sulcus carcinoma, could be a adjuvant rapid axillary scan in determining the third dimension of tumor that is DOI and cervical lymph node metastasis.

颈淋巴结转移龈颊沟鳞癌术前超声浸润深度(DOI)与病理浸润深度(DOI)的比较
引言:头颈癌在该国几个地区的其他癌症中发病率最高,并且在第三人群中仍有上升趋势。肿瘤肿块不是平面的,而是三维生长的,因此外科医生应该了解第三维,即浸润深度(DOI)。如今,先进的技术已经被引入来测量原发肿瘤的术前浸润深度,即超声扫描(USG)。超声(USG)扫描由于其无辐射成像和出色的肿瘤可视化、经济、无创、可自发获得实时图像等优点,仍被认为是术前测量DOI的金标准。本研究的主要目的是评估并比较龈颊沟鳞癌伴颈结转移的术前超声浸润深度(DOI)与组织病理学DOI。材料和方法学:这是一项单中心前瞻性研究,包括51例于2019年11月至2021年11月在我们单位报告的接受手术的患者。所有患者术前均行病变USG评估,记录DOI。同样,术后对所有切除标本进行组织病理学DOI检查。术前USG检查值与术后组织病理学DOI值进行比较。相关系数分析采用Karl Pearson的散点图和因故t对检验。采用卡方Yates校正检验研究USG DOI与淋巴结转移(LNM)的统计学相关性。结果:共纳入51例患者,其中男性40例(78.4%),女性11例(21.6%)。在这些病例中,术前USG扫描测量的DOI范围从6毫米到37毫米,平均为19.41毫米。所有患者的组织病理学DOI测量范围为1.3 mm至16 mm,平均为7.26 mm。术前USG扫描测量的DOI与术后(组织学)测量的DOI之间的p值为0.0316,具有统计学意义。51例患者中15例(29.41%)颈淋巴结转移呈USG阳性。经Yates校正= 0.2721,P = 0.6020的卡方检验,发现USG DOI与颈淋巴结转移的发生存在相关性。结论:DOI显然是一种潜在有用且客观可测量的预后工具。术前使用USG成像研究来正确定位病变的延伸,并测量肿瘤最深处的侵入区域。术前,获得的DOI数据有助于外科医生计划疾病的三维清除。虽然USG扫描不能早期发现龈颊沟癌的骨浸润,但可以作为一种辅助快速腋窝扫描来确定肿瘤的三维空间,即DOI和颈部淋巴结转移。
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来源期刊
CiteScore
5.30
自引率
7.70%
发文量
537
审稿时长
2-4 weeks
期刊介绍: Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.
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