文章：

口腔内超声与磁共振成像在口腔舌鳞状细胞癌浸润深度测量中的比较：一项前瞻性诊断准确性研究

Intraoral Ultrasound versus MRI for Depth of Invasion Measurement in Oral Tongue Squamous Cell Carcinoma: A Prospective Diagnostic Accuracy Study

原文发布日期：1 February 2024

DOI: 10.3390/cancers16030637

类型: Article

开放获取: 是

英文摘要：

Oral squamous cell carcinoma (OSCC) of the tongue is the most common type of oral cavity cancer, and tumor depth of invasion (DOI) is an important prognostic factor. In this study, we investigated the accuracy of intraoral ultrasound and magnetic resonance imaging (MRI) for assessing DOI in patients with OSCC. Histopathological measurement of DOI was used as a reference standard. We conducted a prospective study including patients planned for surgical treatment of OSCC in the tongue. The DOI was measured in an outpatient setting by intraoral ultrasound and MRI, and was compared to the histopathological DOI measurements. Bland–Altman analysis compared the mean difference and 95% limits of agreement (LOA) for ultrasound and MRI, and the Wilcoxon signed-rank test was used to test for significance. The correlation was evaluated using Pearson’s correlation coefficient. We included 30 patients: 26 with T1 or T2 tumors, and 4 with T3 tumors. The mean difference from histopathology DOI was significantly lower for ultrasound compared to MRI (0.95 mm [95% LOA −4.15 mm to 6.06 mm] vs. 1.90 mm [95% LOA −9.02 mm and 12.81 mm],p= 0.023). Ultrasound also led to significantly more correct T-stage classifications in 86.7% (26) of patients compared to 56.7% (17) for MRI,p= 0.015. The Pearson correlation between MRI and histopathology was 0.57 (p< 0.001) and the correlation between ultrasound and histopathology was 0.86 (p< 0.001). This prospective study found that intraoral ultrasound is more accurate than MRI in assessing DOI and for the T-staging of oral tongue cancers. Clinical practice and guidelines should implement intraoral ultrasound accordingly.

摘要翻译： 

舌部口腔鳞状细胞癌是口腔癌中最常见的类型，肿瘤浸润深度是其重要的预后因素。本研究旨在评估口内超声与磁共振成像对舌部口腔鳞状细胞癌患者肿瘤浸润深度测量的准确性，并以组织病理学测量结果作为参考标准。我们开展了一项前瞻性研究，纳入计划接受手术治疗的舌部口腔鳞状细胞癌患者。在门诊环境中分别采用口内超声和磁共振成像测量肿瘤浸润深度，并与术后组织病理学测量结果进行对比。通过Bland-Altman分析比较两种影像学方法与病理测量结果的平均差异及95%一致性界限，采用Wilcoxon符号秩检验评估差异显著性，并通过Pearson相关系数评价相关性。研究共纳入30例患者，其中26例为T1或T2期肿瘤，4例为T3期肿瘤。口内超声测量结果与病理浸润深度的平均差异显著低于磁共振成像（0.95毫米[95%一致性界限-4.15至6.06毫米]对比1.90毫米[95%一致性界限-9.02至12.81毫米]，p=0.023）。在T分期准确性方面，口内超声达到86.7%（26例）的正确率，显著高于磁共振成像的56.7%（17例）（p=0.015）。磁共振成像与病理测量结果的Pearson相关系数为0.57（p<0.001），而口内超声与病理测量结果的相关系数达0.86（p<0.001）。本前瞻性研究表明，在评估舌部口腔鳞状细胞癌的肿瘤浸润深度及T分期方面，口内超声较磁共振成像具有更高的准确性。临床实践及相关指南应据此推广应用口内超声技术。

原文链接：

Intraoral Ultrasound versus MRI for Depth of Invasion Measurement in Oral Tongue Squamous Cell Carcinoma: A Prospective Diagnostic Accuracy Study