超声检查诊断口腔鳞状细胞癌颈淋巴结转移之方法探讨

目的：探讨超声检查诊断口腔鳞状细胞癌颈淋巴结转移的方法。方法：１９名口腔鳞状细胞癌患者经二维超声检查,共发现肿大的颈淋巴结３４个,记录淋巴结的长短径之比,再对其中１６个淋巴结内有血流者,测量Ｖｍａｘ和Ｖｍｉｎ值,并计算ＲＪ值,其后患者行根治性淋巴结清扫术,解剖出肿大淋巴结作病理检查,最后作各组间对比分析。结果：（１）有癌转移的淋巴结组与无癌转移的淋巴结组间ＲＪ值具有显著性差异,而两组间淋巴结长短径

Effects of Ultrasonography on Evaluating the Status of Cervical Lymphatic Metastasiv in Patients with Oral Squamous Cell Carcinoma

OBJECTIVE: To investigate effects of ultrasonography on evaluating the status of cervical lymphatic metastasis in patients with oral squamous cell carcinoma (OSCC). METHODS: Nineteen OSCC patients with the diagnosis confirmed by biopsy of primary focus were included in this study. All the patients were hospitalized in the department of stomatology, Beijing Medical University during June, 1995 and June, 1996, among them there were 13 men and 6 women. The ages were ranged from 31 to 71 years old, with the average of 54.4 years old. The primary focus of 13 cases were in tongue, 3 cases in cheek, 2 cases in gum, and 1 case in the conjunction of gum, mouth floor and tongue respectively. All the patients were examined by ultrasonography prior to operation, and operated with the procedures of excision of primary focus and radical neck dissection. The length, width, Vmax and Vmin and Resistance Index (RI = (Vmax-Vmin)/Vmax) of blood flow of cervical lymphatic nodes were measured with acuson 128 xp/10 color Doppler flow imaging scanner with a 7.5 MHz probe. The total of 34 cervical lymphatic nodes were examined by the scanner. L/W ratios in all nodes, RI and Vmax in 16 nodes were obtained respectively. All results were divided into two groups, metastases and non-metastases groups based on the pathological findings for further statistic analysis. Student t test was employed in the study. RESULTS: The average L/W ratios, the average Vmax and the average RI were 1.95 and 2.17, 0.24 and 0.14, and 0.80 and 0.56 in metastases and non-metastases groups respectively. There was a significant difference between RI in two groups, but no statistical differences were revealed in L/W ratios and Vmax, despite the great difference in the average Vmax in the two groups. When RI > or = 0.65 and Vmax > or = 0.20 m/s were regarded as the criterion for positive diagnosis, the accuracy rate, the sensibility and the specificity was 91.2%, 90%, and 91.7% respectively in making diagnosis of OSCC. CONCLUSION: The status of cervical lymphatic metastases in OSCC patients could be evaluated accurately by the color Doppler flow imaging scanner, which might be helpful in making accurately diagnosis of OSCC, selecting the appropriate operation procedure of neck dissection leading to increased survival ratio and improved quality of life for the patients.