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Wednesday, November 17, 2021

Comparison of the value of ultrasound and enhanced magnetic resonance imaging in judging cervical lymph node metastasis in patients with oral cancer

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Bull Cancer. 2021 Nov 12:S0007-4551(21)00423-9. doi: 10.1016/j.bulcan.2021.09.010. Online ahead of print.

ABSTRACT

BACKGROUND: Oral cancer is the twelfth largest malignant tumor in the world. Oral cancer is prone to lymph node metastasis in the early stages of the disease, and lymph node metastasis will directly affect the treatment and survival rate. Therefore, whether the lymph node metastasis can be accurately evaluated is of great significance to the treatment and prognosis of patients.

OBJECTIVE: The diagnostic efficacy of three methods of preoperative ultrasound, enhanced magnetic resonance (enhanced MR), and ultrasound combined with enhanced MR on cervical lymph node metastasis of oral cancer were compared.

MATERIALS AND METHODS: A retrospective analysis of 399 cases of oral cancer completed by head and neck surgery at Cancer Center of Sun Yat-sen University, China. In all cases, the maxillofacial and neck enhanced M R and cervical lymph node ultrasound examinations were performed before surgery, and imaging diagnosis was made for cervical lymph node metastasis and compared with pathology. All judgment results were statistically processed using the chi-square test.

RESULTS: Compared with the above three methods, the diagnostic efficiency of ultrasound alone is better, and the diagnostic efficiency of enhanced MR combined ultrasound is not significantly better than that of ultrasound alone. There are differences in the diagnostic efficacy of the three inspection methods in different clinical sub-periods, all of which are better for the diagnosis of stage I. For patients with stage I, II, and III, there were no differences between the three examination methods. However, for stage IV patients,the diagnostic efficiency of ultrasound alone is better. For patients with stage N0, there was no difference in diagnostic efficacy between the three methods. For the assessment of lymph nodes in the I-I II region, there are differences between the three methods of examination: the diagnostic efficiency of ultrasound alone is better, and enhanced MR combined ultrasound is not significantly better than ultrasound alone. For the evaluation of lymph nodes in the IV-VII region, there was no difference in diagnostic efficacy between the three methods.

CONCLUSION: According to the clinical characteristics and prognosis of patients with oral cancer, although enhanced MR can better evaluate the tumor, ultrasound may be considered as the preferred imaging method for cervical lymph node metastasis.

SIGNIFICANCE: Accurate assessment and proper and timely treatment of lymph node metastasis can help improve the survival rate of patients.

PMID:34782121 | DOI:10.1016/j.bulcan.2021.09.010

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