Abstract:
A prospective cross-sectional study was conducted to correlate clinically, radiologically, and pathologically the mandibular invasion in carcinoma bucco-alveolar complex. All biopsy-proven oral cavity cancer cases (64 patients) were assessed clinically and radiologically for involvement of the mandible. Preoperative clinicoradiological findings were compared with postoperative histopathological findings. In our study, oral cancer was 4 times more prevalent in males as compared to females and clinical evaluation was found to be highly sensitive in predicting mandibular invasion. Orthopantomogram showed sensitivity of 66.6% and specificity of 100%. CT scan showed sensitivity of 100% and specificity of 46% whereas MRI showed sensitivity of 54.5% and a specificity of 96%. MRI correlates well with final histopathology in predicting size of tumor. Prevalence of bony invasion in carcinoma oral cavity was 18%. We noted an inverse relation with tumor differentiation and mandibular invasion, and none of the verrucous carcinoma lesions showed mandibular invasion. Association of clinical T and N staging with postoperative histopathology was found to be statistically significant. Despite recent advances in molecular biology, radiological techniques, and newer modalities like visual surgical planning, exact measurement of bone invasion is still challenging. At present, CT scan and MRI along with clinical evaluation are widely used to evaluate mandibular invasion in carcinoma oral cavity, and all these are complementary to each other. The recent progress in tissue engineering technologies and stem cell biology has significantly promoted the development of regenerative reconstruction of jawbone defects.
摘要:
进行了一项前瞻性横断面研究,以临床上,放射学,病理上是癌颊牙槽复合体的下颌侵犯。对所有经活检证实的口腔癌病例(64例患者)进行了下颌骨受累的临床和放射学评估。将术前临床放射学结果与术后组织病理学结果进行比较。在我们的研究中,与女性相比,男性口腔癌的患病率是女性的4倍,并且发现临床评估在预测下颌骨侵犯方面非常敏感。直视图显示灵敏度为66.6%,特异性为100%。CT扫描显示灵敏度为100%,特异性为46%,而MRI显示灵敏度为54.5%,特异性为96%。MRI在预测肿瘤大小方面与最终组织病理学密切相关。口腔癌骨性浸润的患病率为18%。我们注意到与肿瘤分化和下颌骨侵犯呈负相关,疣状癌病变均未显示下颌骨侵犯。发现临床T和N分期与术后组织病理学的关联具有统计学意义。尽管分子生物学最近取得了进展,放射技术,和新的模式,如视觉手术计划,骨侵入的精确测量仍然具有挑战性。目前,CT扫描和MRI以及临床评估广泛用于评估口腔癌的下颌骨侵犯,所有这些都是相辅相成的。组织工程技术和干细胞生物学的最新进展极大地促进了颌骨缺损再生重建的发展。