摘要
目的研究舌癌MRI表现及MRI对舌癌术前分期的价值,以指导临床分期,制定最佳治疗方案.方法前瞻性分析39例舌癌患者,行MRI检查;分析其MRI征象,术前MRI分期,并与病理结果进行对照研究.结果MRI对肿瘤的累及部位、深度和范围有较好显示,但对小淋巴结的检测和鉴别淋巴结的性质存在困难.MRI对原发灶T1～T4TNM分期敏感性分别为100%、83.3%、90.9%和82.6%,特异性为63.5%、83.5%、63.6%和82.6%;判断淋巴结转移的敏感性为60.8%.特异性为75.0%,准确性为66.7%,阳性预测值为77.8%,阴性预测值为76.2%;术前AJCC分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期敏感性分别为100%、85.7%、92.3%和88.9%,特异性分别为66.7%、76.3%、76.9%和77.8%.舌癌浸润深度小于3、3～6、6～9和大于9 mm 4组的淋巴结转移有明显差异(P<0.05),6～9 mm组与大于9 mm组之间无明显差异(P<0.05).结论MRI可作为舌癌TNM分期、AJCC分期的重要依据,MRI征象、临床表现结合舌癌浸润深度可提高舌癌术前分期准确性.
Objective To study the features of tongue carcinoma in magnetic resonance imaging (MRI) and the value of MRI in the preoperative clinical staging of malignancy. Methods Thirty-nine patients with tongue carcinoma underwent MRI examination, the findings of which were analyzed for staging of the tumors in comparison with the pathological findings. Results MRI showed good performance in displaying tumor invasion, invasion depth and extension but failed in distingui- shing and qualitative identification of the lymph nodes less than 1 cm. The sensitivity of MRI for clinical staging of T1, T2, T3, and T4 primary tumors, in accordance with tumor node metastasis (TNM) staging system, was 100%, 83.3%, 90.9% and 82.6% with specificity of 73.5%, 83.5%, 63.6% and 82.6%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value for diagnosis of the lymph nodes were 60.8%, 75.0%, 77.8% and 76.2%, respectively. The sensitivity of MRI for the American Joint Committee on Cancer (AJCC) staging was 100%, 85.7%, 92.3% and 88.9%, respectively for stage Ⅰ,Ⅱ,Ⅲand Ⅳtumors, with specificity of 66.7%, 76.3%, 76.9% and 77.8%, respectively. Lymph nodes metastasis occurred in 0%, 37.5%, 81.6% and 88.2% of the cases with tumor invasion depth of less than 3, 3-6, 6-9 and more than 9 mm respectively, without any significant differences between the latter 2 groups of cases (P>0.05). Conclusion MRI offers important evidence for TNM and AJCC staging of tongue carcinoma, and the MRI features in conjunction with clinical manifestations and tumor invasion depth are instrumental in improving the accuracy of preoperative staging of the tumors.
出处
《第一军医大学学报》
CSCD
北大核心
2003年第8期841-843,共3页
Journal of First Military Medical University
关键词
舌肿瘤
肿瘤分期
磁共振成像
tongue neoplasms
tumor staging
magnetic resonance imaging(MRI)
