Despite advancements in multidisciplinary care, oncologic outcomes of oral cavity squamous cell carcinoma (OSCC) have not substantially improved: still, one-third of patients affected by stage I and II can develop locoregional recurrences. Imaging plays a pivotal role in preoperative staging of OSCC, providing depth of invasion (DOI) measurements. However, locoregional recurrences have a strong association with adverse histopathological factors not included in the staging system, and any imaging features linked to them have been lacking. In this study, the possibility to predict histological risk factors in OSCC with high-frequency intraoral ultrasonography (IOUS) was evaluated. Thirty-four patients were enrolled. The agreement between ultrasonographic and pathological DOI was evaluated, and ultrasonographic margins’ appearance was compared to the Brandwein-Gensler score and the worst pattern of invasion (WPOI). Excellent agreement between ultrasonographic and pathological DOI was found (mean difference: 0.2 mm). A significant relationship was found between ultrasonographic morphology of the front of infiltration and both Brandwein-Gensler score ≥ 3 (p< 0.0001) and WPOI ≥4 (p= 0.0001). Sensitivity, specificity, positive predictive value, and negative predictive value for the IOUS to predict a Brandwein-Gensler score ≥3 were 93.33%, 89.47%, 87.50%, and 94.44%, respectively. The present study demonstrated the promising role of IOUS in aiding risk stratification for OSCC patients.
尽管多学科诊疗取得进展，口腔鳞状细胞癌（OSCC）的肿瘤学预后仍未显著改善：仍有三分之一I期和II期患者可能出现局部区域复发。影像学在OSCC术前分期中发挥着关键作用，可提供肿瘤浸润深度（DOI）测量数据。然而，局部区域复发与分期系统未涵盖的不良组织病理学因素密切相关，且目前缺乏与之相关的影像学特征。本研究评估了高频口内超声（IOUS）预测OSCC组织学风险因素的可行性。共纳入34例患者，评估超声与病理DOI测量的一致性，并将超声边缘形态与Brandwein-Gensler评分及最差浸润模式（WPOI）进行对比。结果显示超声与病理DOI测量具有极佳一致性（平均差异：0.2毫米）。浸润前沿的超声形态学特征与Brandwein-Gensler评分≥3（p<0.0001）及WPOI≥4（p=0.0001）均存在显著相关性。IOUS预测Brandwein-Gensler评分≥3的敏感性、特异性、阳性预测值和阴性预测值分别为93.33%、89.47%、87.50%和94.44%。本研究表明IOUS在辅助OSCC患者风险分层方面具有重要应用前景。
肿瘤(癌症)患者之家