颈部超声用于咽部和喉部鳞状细胞癌术前T分期评估及患者层面颈部淋巴结转移检测：以病理结果为参考标准与增强CT和MRI的比较
Cervical ultrasonography for preoperative T assessment and patient-level detection of cervical nodal metastasis in pharyngeal and laryngeal squamous cell carcinoma: comparison with contrast-enhanced CT and MRI using pathological findings as the reference standard.
文献信息
| PMID | 42864872 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Takafumi Yamada |
| 作者单位 | Department of Radiology, Tokyo Medical University Hospital, Tokyo, Japan. |
| 期刊 | Acta oto-laryngologica |
| SCI 分区 | Q3 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 颈部超声（US）可能补充横断面成像用于咽部和喉部鳞状细胞癌的淋巴结评估。
目的/目标： 以病理为参考标准，比较US与增强CT和MRI在患者层面检测颈部淋巴结转移的能力；T分期性能为次要目标。
材料和方法： 这项回顾性研究纳入107例接受手术治疗的患者。CT和MRI由两名对病理不知情的放射科医师重新评估，而US分类从临床报告中提取。在72例接受颈淋巴结清扫的患者中评估淋巴结性能。
结果： 对于N阳性疾病，US的敏感性、特异性和准确性分别为81.2%、79.2%和80.6%。在匹配的N队列（n=41）中，US、CT和MRI的正确分类率分别为82.9%、80.5%和90.2%（p=0.395）。US原发肿瘤评估在107例患者中可评估54例（50.5%）；对T3-4疾病的敏感性、特异性和准确性分别为45.5%、90.5%和63.0%。在匹配的T队列（n=30）中，正确分类率分别为56.7%、80.0%和76.7%（p=0.028）；Holm校正后无任何两两比较仍显著。
结论和意义： US可能补充可触及颈部淋巴结的评估，但原发肿瘤适用性有限。CT和MRI对于评估原发肿瘤范围和深部淋巴结疾病仍然必不可少。
英文摘要
BACKGROUND: Cervical ultrasonography (US) may complement cross-sectional imaging for nodal assessment in pharyngeal and laryngeal squamous cell carcinoma.
AIMS/OBJECTIVES: To compare US with contrast-enhanced CT and MRI for patient-level detection of cervical nodal metastasis using pathology as the reference standard; T-staging performance was secondary.
MATERIAL AND METHODS: This retrospective study included 107 surgically treated patients. CT and MRI were reassessed by two pathology-blinded radiologists, whereas US classifications were extracted from clinical reports. Nodal performance was evaluated in 72 patients with neck dissection.
RESULTS: For N-positive disease, US sensitivity, specificity, and accuracy were 81.2%, 79.2%, and 80.6%. In the matched N cohort (n = 41), correct classification rates were 82.9%, 80.5%, and 90.2% for US, CT, and MRI (p = 0.395). US primary-tumour assessment was evaluable in 54 of 107 patients (50.5%); sensitivity, specificity, and accuracy for T3-4 disease were 45.5%, 90.5%, and 63.0%. In the matched T cohort (n = 30), correct classification rates were 56.7%, 80.0%, and 76.7% (p = 0.028); no pairwise comparison remained significant after Holm adjustment.
CONCLUSIONS AND SIGNIFICANCE: US may complement assessment of accessible cervical nodes, but primary-tumour applicability is limited. CT and MRI remain essential for assessment of primary-tumour extent and deep nodal disease.