老年人口腔鳞癌颈淋巴结转移CT诊断标准的病理学再评价

目的：虽然CT和MRI对口腔颌面部鳞癌颈淋巴结转移的诊断具有很大的帮助，但评价颈部淋巴结病变的方法仍有缺陷。本文对颈淋巴结转移的影像学诊断标准进行再评价。方法：运用显微病理方法检查了口腔颌面部鳞癌病人42例，颈淋巴结清扫术的1722个淋巴结的形态学特征。结果：37％恶性转移淋巴结的直径小于10mm，而淋巴结结外膨隆在很小的淋巴结也可发现。结论：目前，评价颈淋巴结状态的影像学标准主要建立在淋巴结的大小上，本文结果提示，现有的影像学诊断标准，对判断颈淋巴结转移存在局限性，本文旨在对改善口腔颌面部鳞癌颈淋巴结转移诊断的新方法进行讨论。

CT scanning of the cervical lymph node metastases in old patients: Acomparision with pathological results

Objective: Although computed tomography and magnetic resonance imaging have contributed to the detection of metastatic disease in head and neck cancer, inadequacies in evaluating lymphadenopathy still exist. This study was designed to compare CT scans of metastatic lymph node with corresponding histologic sections on 42 dissections in total. Methods: The morphological characteristics of 1722 lymph nodes from 42 neck dissections in patients with squamous cell cancer were examined microscopically. Results: With pathological findings as the standard, sensitivity, specificity and accuracy of CT in the detection of nodal disease were 33.0%,95.0% and 65.3%. A large number of malignant nodes were found to have diameters of less than 10mm. Extranodal spread also occurred in a substantial percentage of smaller nodes. Conclusion: Because the present radiological criteria for assessing cervical lymph node status are based largely on size, findings indicate major limitations in the capabilities of detecting metastatic disease. New modalities to improve the staging of head and neck cancer are discussed.