不同HPV感染状态口咽部及头颈部原发部位不明鳞状细胞癌颈部转移性淋巴结超声鉴别诊断  

Ultrasound Features of HPV-positive and HPV-negative Cervical Metastatic Lymph Nodes with Squamous Cell Carcinomas of the Oropharynx and Unknown Primary Site in the Head and Neck

作　　者：陈倩倩[1] 周辉红[1] 张蔚蒨[1] 袁方[1] 孙晶晶[2] 熊屏[1] Chen Qianqian;Zhou Huihong;Zhang Weiqian;Yuan Fang;Sun Jingjing;Xiong Ping(Department of Ultrasound Medicine,Ninth People's Hospital,Shanghai Jiaotong University,School of Medicine,Shanghai 20o01l,China;Department of Oral Pathology,Ninth People's Hospital,Shanghai Jiaotong University,School of Medicine,Shanghai 20o01l,China)

机构地区：[1]上海交通大学医学院附属第九人民医院超声医学科,上海市200011 [2]上海交通大学医学院附属第九人民医院口腔病理科,上海市200011

出　　处：《中国超声医学杂志》2023年第6期634-636,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨不同人乳头状瘤病毒(HPV)感染状态下口咽部鳞状细胞癌(OPSCC)、头颈部原发部位不明鳞状细胞癌(HNSCC-UP)的颈部转移性淋巴结(CMLN)的声像图特点及鉴别诊断,对HPV感染状态进行术前预测。方法 回顾性分析39例不同HPV感染状态的OPSCC、HNSCC-UP的74个CMLN的超声图像。分析的特征包括:形态、短长径比(S/L)、边界、淋巴结门结构、内部回声、钙化、液化坏死。结果 不同HPV感染状态的OPSCC、HNSCC-UP的CMLN在形态、内部回声、钙化方面有统计学意义(P<0.05),在S/L、边界、淋巴结门结构方面的差异无统计学意义(P>0.05)。结论 HPV(-)OPSCC的CMLN内部回声多不均匀,钙化是其超声特征;而形态不规则的CMLN多与HPV(+)OPSCC、HNSCC-UP相关。Objective To explore the sonographic characteristics and value for differential diagnosis of cervical metastatic lymph node with HPV-negative oropharyngeal squamous cell carcinoma(OPSCC),HPV-positive OPSCC and HPV-positive head and neck squamous cell carcinoma of unknown primary(HNSCC-UP)in order to predict the status of HPV infection before operation.Methods A total 39 OPSCC and HNSCC-UP patients with 74 metastatic lymph nodes were enrolled in this study.The ultrasound features of nodes included contour,short to long axis ratio(S/L),border,echogenic hilus,echogenictiy,calcification.Results The differences in contour,echogenictiy,calcification between HPV-negative and positive ones were statistically significant(P<0.05).There were no statistically significant differences in S/L,border,and lymphatic structure(P>0.05).Conclusions Heterogeneous echotexture is more commonly seen in cervical metastatic lymph nodes of HPV-negative OPSCC,which is characteristic of calcification.In contrast,cervical metastatic lymph nodes of HPV-positive OPSCC and HNSCC-UP show irregular contours on ultrasound.

关 键 词：超声 人乳头状瘤病毒 口咽部鳞状细胞癌 头颈部原发部位不明鳞状细胞癌 颈部转移性淋巴结 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.91[医药卫生—诊断学]