循环肿瘤细胞联合增强CT对口腔鳞状细胞癌术前淋巴结转移评估的临床意义  

Significance of CTC Detection Combined with Enhanced CT in Preoperative Evaluation of Lymph Node Metastasis of Oral Squamous Cell Carcinoma

作　　者：李雯[1] 李杨[1] 朱保玉 Li Wen;Li Yang;Zhu Baoyu(Dept.Of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院口腔颌面外科,郑州450052

出　　处：《河南外科学杂志》2022年第4期23-26,共4页Henan Journal of Surgery

摘　　要：目的探讨口腔鳞状细胞癌(OSCC)患者术前增强CT联合循环肿瘤细胞(CTC)评估颈部淋巴结转移的临床意义。方法选取郑州大学第一附属医院口腔颌面外科76例术前颈部增强CT提示OSCC颈部淋巴结转移(最大淋巴结短径≥10 mm)患者的临床资料,以术后病理结果为金标准,采用卡方检验和秩和检验分析OSCC的影响因素,并使用ROC曲线评价CTC检测联合增强CT的诊断效能。结果术前增强CT诊断OSCC患者淋巴结转移的假阳性率为59.21%(45/76)。患者性别(P=0.003)及术前循环肿瘤细胞(P=0.002)均为临床判断淋巴结转移的影响因素。ROC曲线分析显示:以CTC≥10.05为术前临床判断淋巴结转移的最佳标准,曲线下面积为0.702,敏感度为87.10%,特异度为46.67%,准确率为63.16%,尤登指数为0.34。结合术前增强CT和CTC进行筛选后,假阳性率降至31.58%(24/76)。结论血清CTC升高是OSCC淋巴结转移的危险因素,结合术前血清CTC检测,可明显降低增强CT对术前OSCC患者淋巴结转移评估的假阳性率。Objective To investigate the clinical significance of circulating tumor cell(CTC)detection combined with preoperative enhanced CT in the evaluation of lymph node metastasis of oral squamous cell carcinoma(OSCC)patients.Methods The clinical data of 76 patients with cervical lymph node metastasis(the maximum lymph nodes short diameter≥10 mm)of OSCC were selected from the Department of oral and maxillofacial surgery,the First Affiliated Hospital of Zhengzhou University.Taking the postoperative pathological results as the gold standard,the influencing factors of OSCC were analyzed by chi-square test and rank-sum test,and the diagnostic efficiency of CTC combined with enhanced CT was evaluated by ROC curve.Results The false positive rate of preoperative enhanced CT in the diagnosis of lymph node metastasis in patients with OSCC was 59.21%(45/76).Gender(P=0.003)and preoperative circulating tumor cells(P=0.002)were the influencing factors of clinical judgment of lymph node metastasis.ROC curve analysis showed that taking CTC≥10.05 as the best standard for preoperative clinical judgment of lymph node metastasis,the area under the curve was 0.702,the sensitivity was 87.10%,the specificity was 46.67%,the accuracy was 63.16%,and the Uden index was 0.34.After screening with preoperative enhanced CT and CTC,the false positive rate decreased to 31.58%(24/76).Conclusion The increase of serum CTC is a risk factor for lymph node metastasis of OSCC.The combination of preoperative serum CTC detection can significantly reduce the false positive rate of enhanced CT for preoperative evaluation of lymph node metastasis of OSCC.

关 键 词：口腔鳞状细胞癌 淋巴结转移 增强CT 循环肿瘤细胞 

分 类 号：R782[医药卫生—口腔医学]