{"title":"非口咽活检在原发灶不明的头颈部鳞状细胞癌中的作用：系统综述","authors":"C. M. Bowe, M. Garg","doi":"10.1111/coa.14157","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>This systematic review aims to evaluate the role of biopsies in non-oropharyngeal subsites in patients with cervical metastasis from head and neck squamous cell carcinoma of unknown primary (HNSCCUP).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles that encompassed non-oropharyngeal biopsies in HNSCCUP as part of the diagnostic work-up were selected and analysed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A comprehensive search strategy was used to search relevant literature in PubMed from inception to October 2021. Eleven articles out of 860 were included, comprising 990 patients. There are no randomised control trials comparing the outcomes of survival and or locoregional control between patients who have or have not undergone non-targeted biopsies of non-oropharyngeal sub-sites for HNSCCUP.</p>\n \n <p>Several retrospective studies which showed an extremely low yield from random biopsies (range of yield, 0%–9%) of non-oropharyngeal subsites. Even targeted biopsies showed a low yield (range of yield, 0.6%–16.6%) from non-oropharyngeal subsites. The primary site identified for Epstein–Barr virus (EBV) positive cervical lymph nodes with an unknown primary is mainly the nasopharynx (51.7%). Narrow band imaging (NBI) (sensitivity range, 64%–91%) helps in the detection of primaries to target biopsies in non-oropharyngeal subsites.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>On the basis of this systematic review, it is not appropriate to offer biopsies of clinically and radiologically normal upper aerodigestive tract mucosa at non-oropharyngeal sites. Offer nasopharyngeal biopsies when the cervical node sampling reveals EBV-positive metastasis. Where available, NBI should be used to help detect and target biopsies in non-oropharyngeal subsites.</p>\n </section>\n </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 5","pages":"531-537"},"PeriodicalIF":1.7000,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14157","citationCount":"0","resultStr":"{\"title\":\"The role of non-oropharyngeal biopsies in head and neck squamous cell carcinoma of unknown primary: A systematic review\",\"authors\":\"C. M. Bowe, M. Garg\",\"doi\":\"10.1111/coa.14157\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>This systematic review aims to evaluate the role of biopsies in non-oropharyngeal subsites in patients with cervical metastasis from head and neck squamous cell carcinoma of unknown primary (HNSCCUP).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles that encompassed non-oropharyngeal biopsies in HNSCCUP as part of the diagnostic work-up were selected and analysed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A comprehensive search strategy was used to search relevant literature in PubMed from inception to October 2021. Eleven articles out of 860 were included, comprising 990 patients. There are no randomised control trials comparing the outcomes of survival and or locoregional control between patients who have or have not undergone non-targeted biopsies of non-oropharyngeal sub-sites for HNSCCUP.</p>\\n \\n <p>Several retrospective studies which showed an extremely low yield from random biopsies (range of yield, 0%–9%) of non-oropharyngeal subsites. Even targeted biopsies showed a low yield (range of yield, 0.6%–16.6%) from non-oropharyngeal subsites. The primary site identified for Epstein–Barr virus (EBV) positive cervical lymph nodes with an unknown primary is mainly the nasopharynx (51.7%). Narrow band imaging (NBI) (sensitivity range, 64%–91%) helps in the detection of primaries to target biopsies in non-oropharyngeal subsites.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>On the basis of this systematic review, it is not appropriate to offer biopsies of clinically and radiologically normal upper aerodigestive tract mucosa at non-oropharyngeal sites. Offer nasopharyngeal biopsies when the cervical node sampling reveals EBV-positive metastasis. 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The role of non-oropharyngeal biopsies in head and neck squamous cell carcinoma of unknown primary: A systematic review
Introduction
This systematic review aims to evaluate the role of biopsies in non-oropharyngeal subsites in patients with cervical metastasis from head and neck squamous cell carcinoma of unknown primary (HNSCCUP).
Methods
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles that encompassed non-oropharyngeal biopsies in HNSCCUP as part of the diagnostic work-up were selected and analysed.
Results
A comprehensive search strategy was used to search relevant literature in PubMed from inception to October 2021. Eleven articles out of 860 were included, comprising 990 patients. There are no randomised control trials comparing the outcomes of survival and or locoregional control between patients who have or have not undergone non-targeted biopsies of non-oropharyngeal sub-sites for HNSCCUP.
Several retrospective studies which showed an extremely low yield from random biopsies (range of yield, 0%–9%) of non-oropharyngeal subsites. Even targeted biopsies showed a low yield (range of yield, 0.6%–16.6%) from non-oropharyngeal subsites. The primary site identified for Epstein–Barr virus (EBV) positive cervical lymph nodes with an unknown primary is mainly the nasopharynx (51.7%). Narrow band imaging (NBI) (sensitivity range, 64%–91%) helps in the detection of primaries to target biopsies in non-oropharyngeal subsites.
Conclusions
On the basis of this systematic review, it is not appropriate to offer biopsies of clinically and radiologically normal upper aerodigestive tract mucosa at non-oropharyngeal sites. Offer nasopharyngeal biopsies when the cervical node sampling reveals EBV-positive metastasis. Where available, NBI should be used to help detect and target biopsies in non-oropharyngeal subsites.
期刊介绍：
Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with:
current otorhinolaryngological practice
audiology, otology, balance, rhinology, larynx, voice and paediatric ORL
head and neck oncology
head and neck plastic and reconstructive surgery
continuing medical education and ORL training
The emphasis is on high quality new work in the clinical field and on fresh, original research.
Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject.
• Negative/null results
In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
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