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首页> 外文期刊>日本耳鼻咽喉科学会会報 >Usefulness and limitations in ultrasonography for diagnosing neck lymph node metastases in patients with hypopharyngeal squamous cell carcinoma: comparison with pathological findings following neck dissection
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Usefulness and limitations in ultrasonography for diagnosing neck lymph node metastases in patients with hypopharyngeal squamous cell carcinoma: comparison with pathological findings following neck dissection

机译：超声检查诊断颈部鳞状细胞癌患者颈部淋巴结转移的有用性和限制：颈部解剖后病理结果的比较

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摘要

We evaluated the usefulness and limitations in ultrasonography (US) for diagnosing neck lymph node metastases in patients with hypopharyngeal cancer by comparing the results of preoperative US examinations with postoperative pathological findings following neck dissection. Seventy-five previously untreated patients with hypopharyngeal squamous cell carcinoma underwent a curative procedure that included neck dissection. Preoperatively, all patients were examined by palpation, computed tomography (CT), and US. Postoperatively, all dissected neck lymph nodes were submitted for pathological examination. Results of pre-and postoperative examinations were then compared. US accuracy for each lymph node was 93.9%, while sensitivity was 78.0%, since hypopharyngeal cancer metastasizes early and easily to the neck lymph nodes, and it is difficult to detect small, pathologically positive nodes. Nine of 75 cases showed latent neck recurrence, and two of these were underestimated by US. The major cause for neck recurrence was considered to be the high rate of metastases in such cases, rather than a reduced dissection field. It is not rare to find very small, pathologically positive lymph nodes that US cannot detect in hypopharyngeal cancer. Efforts must therefore be expanded to improve the accuracy of US diagnosis. Care must also be taken when selecting cases for no or limited neck dissection.
机译：通过比较颈部解剖后术后病理发现，我们评估了超声检查（US）用于诊断阴性癌患者颈部淋巴结转移的有用性和限制。七十五个以前未经处理的白糖鳞状细胞癌患者接受了包括颈部解剖的疗法程序。术前，所有患者均被触诊，计算机断层扫描（CT）和美国检查。术后，所有解剖的颈部淋巴结都提交了病理检查。然后比较预先和术后检查的结果。美国每淋巴结的准确性为93.9％，而敏感性为78.0％，因为后咽癌早期且容易地转移到颈部淋巴结，并且很难检测小，病理阳性节点。九个75例患者显示潜在的颈部再次发生，其中两种被美国低估了。在这种情况下，颈部复发的主要原因被认为是在这种情况下的高转移率，而不是减少的解剖场。发现美国无法检测到下咽癌中的非常小的病理阳性淋巴结并不罕见。因此，必须扩大努力以提高美国诊断的准确性。在选择没有或有限的颈部解剖案件时也必须注意。

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