原发性舌鳞癌MRI浸润深度与病理浸润深度的相关性研究  

Correlation between MRI depth of invasion and pathologic depth of invasion in primary tongue squamous cell carcinoma

作　　者：李伟[1] 韩晓峦 杨质彬 何阿仃 韩楠男 张春叶[5] 阮敏[1] 王元银[1] Wei Li;Xiaoluan Han;Zhibin Yang;Ating He;Nannan Han;Chunye Zhang;Min Ruan;Yuanyin Wang(Department of School of Stomatology,Anhui Medical University,Hefei 230001,China;Department of Biological Science,Sihong Hengshan Road Experimental School,Suqian 223900,China;Department of Oral and Maxillofacial Head and Neck Oncology,The Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,National Center for Stomatology,National Clinical Medical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai 200011,China;School of Stomatology,Weifang Medical University,Weifang 261053,China;Department of Oral Pathology,The Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]安徽医科大学口腔医学院,合肥市230032 [2]泗洪县衡山路实验学校生物科学学科 [3]上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室 [4]潍坊医学院口腔医学院 [5]上海交通大学医学院附属第九人民医院口腔病理科

出　　处：《中国肿瘤临床》2024年第19期974-979,共6页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金(编号:82072983);上海市“医苑新星”青年医学培养计划(编号:沪[2021]99号);上海交通大学医学院附属第九人民医院临床研究助推计划(编号:JYLJ202207);上海交通大学医学院附属第九人民医院生物样本库项目(编号:YBKA202203);上海交通大学医学院双百人计划(编号:2022sbr-rm)资助。

摘　　要：目的:探讨原发性舌鳞状细胞癌(tongue squamous cell carcinoma,TSCC)的术前磁共振浸润深度(MRI depth of invasion,MRI-DOI)与术后病理浸润深度(pathologic DOI,p-DOI)之间的相关性。方法:回顾性选取2015年1月至2018年12月上海交通大学医学院附属第九人民医院经病理证实的TSCC患者入组,测量p-DOI,分析p-DOI与患者临床病理参数及预后的关系,进一步回顾性测量MRI-DOI,研究MRI-DOI与p-DOI之间的相关性。结果:入组患者共52例,p-DOI为1~30 mm,平均值(8.5±5.5)mm;p-DOI>5 mm时,P-DOI与肿瘤大小(P=0.021)、肿瘤部位(P=0.047)显著相关;p-DOI≥10 mm时,p-DOI与颈部Ⅲ区淋巴结转移显著相关(P=0.010);p-DOI>7 mm时,与患者的5年生存率最密切相关(P=0.048)。MRI-DOI为3.1~19.9 mm,平均值为(10.3±4.3)mm;MRI-DOI≥10 mm时,与原发性舌鳞癌患者的不良预后密切相关(P=0.043)。MRI-DOI测量值总体略高于p-DOI,平均差值为1.94 mm,相关性较强(r=0.831,P<0.001)。结论:基于MRI的术前放射学DOI测量有助于估计TSCC的术后p-DOI,有助于术前预测肿瘤的侵袭深度,对原发性舌鳞癌外科手术方式的制定及预后评估具有重要的参考价值。Objective:To determine the correlation between the radiologic magnetic resonance imaging(MRI)depth of invasion(MRI-DOI)and pathologic depth of invasion(p-DOI)in oral cavity primary tongue squamous cell carcinoma(TSCC).Methods:Fifty-two cases of pathologically proven primary TSCC were selected from patients admitted to The Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2015 and December 2018.The p-DOI was measured,and the relationship between p-DOI and patients’clinicopathological parameters and prognosis were analyzed.The MRI-DOI was retrospectively measured,and the correlation between MRI-DOI and p-DOI was investigated.Results:Among the 52 patients,the average p-DOI was(8.5±5.5)(1-30)mm.p-DOI was significantly correlated with tumor size(P=0.021)and tumor site(P=0.047)when p-DOI was>5 mm,and significantly correlated with levelⅢlymph node metastasis(P=0.01)when p-DOI was≥10 mm.A close relationship between p-DOI>7 mm and the patient 5-year survival was also demonstrated(P=0.048).The average MRI-DOI was(10.3±4.3)mm,with a maximum of 19.9 mm and a minimum of 3.1 mm.The MRI-DOI≥10 mm also predicted poor survival in patients with TSCC(P=0.043).The MRI-DOI measured was generally slightly higher than p-DOI,with an average difference of 1.94 mm,and a strong correlation was found between MRI-DOI and p-DOI(r=0.831,P<0.001).Conclusions:MRI-based radiologic DOI measurement was useful in estimating postoperative p-DOI,and may help predict the depth of invasion of tumors preoperatively,which has important reference value for treating primary TSCC.

关 键 词：舌鳞状细胞癌 浸润深度 磁共振成像 淋巴结转移 预后 

分 类 号：R739.86[医药卫生—肿瘤]