口腔生物医学 ›› 2023, Vol. ›› Issue (3): 183-187.

• 论著 • 上一篇    下一篇

术前MRI的三维评估在cN0期舌鳞癌患者颈淋巴结转移及预后中的预测价值

黄兴鸿,叶璞,张伟   

  1. 南京医科大学附属淮安第一医院
  • 收稿日期:2022-09-15 修回日期:2023-02-27 出版日期:2023-09-25 发布日期:2023-09-21
  • 通讯作者: 张伟 E-mail:1062681474@qq.com
  • 基金资助:
    南京医科大学科技发展基金

Three-dimensional assessment of cN0 tongue squamous cell carcinoma by preoperative MRI for predicting metastasis of cervical lymph node and prognosis

  • Received:2022-09-15 Revised:2023-02-27 Online:2023-09-25 Published:2023-09-21

摘要: 目的:通过MRI测量cN0期患者舌部病灶的浸润深度及肿瘤体积,并进一步探索浸润深度及肿瘤体积在患者颈淋巴结转移及预后中的预测价值。方法:收集在南京医科大学附属淮安一院手术的cN0期舌鳞癌患者74例,通过IKT-SNAP和3D slicer软件重建舌部病灶并测量其浸润深度及肿瘤体积;通过R语言绘制浸润深度、肿瘤体积与颈淋巴转移之间的ROC曲线并确定临界值;对临床参数与颈淋巴转移的相关性进行Logistic回归分析并通过单因素及多因素COX回归分析影响cN0期舌鳞癌患者预后的独立危险因素。结果:6.3cm3的肿瘤体积和14mm的肿瘤浸润深度可作为临界值来预测颈淋巴结的转移;多因素回归分析表明MRI测量得到的浸润深度可作为影响舌鳞癌患者颈淋巴结转移和预后的独立危险因素(P<0.05);Kaplan-Meier分析表明浸润深度≥14mm的患者有着更差的预后(P<0.05)。结论:MRI测得的浸润深度可作为预测cN0期舌鳞癌患者颈淋巴结转移和预后的独立指标,而肿瘤体积并没有这样的预测能力。

关键词: 舌鳞癌, MRI, 肿瘤体积, 浸润深度, 颈淋巴结转移

Abstract: Objective: Measuring the depth of invasion and tumor volume of tongue lesions in patients with cN0 stage by preoperative MRI, and further exploring the predictive value of depth of invasion and tumor volume in cervical lymph node metastasis and prognosis. Methods: 74 patients clinically diagnosed as cN0 stage tongue squamous cell carcinoma who underwent surgery in the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University were collected. The tongue lesions were reconstructed, then the depth of invasion and volume were measured by IKT-SNAP and 3D slicer software. The ROC curve between the depth of invasion, tumor volume and cervical lymph node metastasis was drawn by R language, and the cutoff value was determined. The correlation between clinical parameters and cervical lymph node metastasis was analyzed by logistic regression, and the independent risk factors affecting the prognosis of patients were analyzed by univariate and multivariate COX regression. Results: Tumor volume of 6.3 cm3 and invasive depth of 14mm as a cutoff value to predict lymph node metastasis; Multivariate analyses revealed that depth of invasion was highly correlated with lymph node metastases and the prognosis of oral cancer (P < 0.05); Kaplan-Meier analysis showed that patients with invasive depth ≥ 14mm had a poor prognosis (P < 0.05). Conclusion: Depth of invasion based on preoperative MRI has the capability to independently predict the lymph node metastases and the prognosis of oral cancer, while three-dimensional Tumor volume did not show the same effect.

Key words: Tongue squamous cell carcinoma, MRI, tumor volume, depth of invasion, cervical lymph node metastasis