背景:在口腔疾病中,口腔癌是死亡的主要原因,并构成严重的健康风险。原发性肿瘤(T)-区域淋巴结(N)-远处转移(M)包括(TNM)分期对于规划口腔鳞状细胞癌(OSCC)患者的治疗策略至关重要。
目的:本研究评估了机构环境下OSCC临床TNM分期与组织病理学分期(pTNM)的预测准确性。
方法:54例连续组织学证实,对手术治疗的OSCC病例进行TNM分期评估。该研究将手术时的临床分期与从切除活检报告中获得的病理分期进行了比较。MicrosoftExcel(Microsoft®Corp.,雷德蒙德,WA,美国)用于数据汇编和描述性分析。卡方检验,方差分析(ANOVA),和Tukey的诚实显着差异(HSD)posthoc检验用于比较数据的统计学意义,使用社会科学统计软件包(IBMSPSSStatisticsforWindows,IBM公司,版本23.0,Armonk,NY).
结果:肺泡粘膜(n=22,40.74%)是最常见的部位,其次是舌头(n=17,31.48%)。在54个案例中,根据临床肿瘤大小,有T1(n=6),T2(n=13),T3(n=13),T4a(n=16)和T4b(n=6)。T2肿瘤通常被升级(n=7),而T4a(n=8)肿瘤最常被降级。T4a(n=8)在临床和组织病理学分期之间具有最佳的一致性,其次是T2、T3和T1。在节点状态下,N1表现出最大的变异。卡方检验显示了肿瘤大小比较(p<0.001)和淋巴结状态比较(p=0.002)的统计学意义。ANOVA检验未显示任何统计学意义。Tukey的HSD后检验对N0和N1状态具有统计学意义(p=0.034)。N0和N1的一致性最高,其次是N2b。
结论:术前放射学和临床评估对于决定患者的疗程至关重要。然而,并非所有患者都需要X线片来确定肿瘤大小或淋巴结状态评估.准确的诊断对于OSCC的治疗计划至关重要。
BACKGROUND: Among oral diseases, oral cancer is the primary cause of death and poses a serious health risk. Primary tumor (T) - regional lymph node (N) - distant metastasis (M) comprising (TNM) staging is crucial for planning treatment strategies for patients with oral squamous cell carcinoma (OSCC).
OBJECTIVE: This study evaluated the predictive accuracy of clinical TNM staging of OSCC to histopathological staging (pTNM) in an institutional setting.
METHODS: Fifty-four consecutive histologically confirmed, surgically treated OSCC cases were evaluated for TNM staging. The study compared the clinical staging at the time of surgery with the pathological staging obtained from excisional biopsy reports. Microsoft Excel (Microsoft® Corp., Redmond, WA, USA) was used for the data compilation and descriptive analysis. The chi-square test, analysis of variance (ANOVA), and Tukey\'s Honest Significant Difference (HSD) posthoc test were used to compare the data for statistical significance with p value <0.05 using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 23.0, Armonk, NY).
RESULTS: The alveolar mucosa (n=22, 40.74%) was the most frequently occurring site, followed by the tongue (n=17, 31.48%). Out of the 54 included cases, based on clinical tumor size, there were T1 (n=6), T2 (n=13), T3 (n=13), T4a (n=16) and T4b (n=6). T2 tumors were usually upstaged (n=7) while T4a (n=8) tumors were most often downstaged. T4a (n=8) had the best concordance between clinical and histopathological staging, followed by T2, T3, and T1. In nodal status, N1 showed the most variation. The chi-squared test showed statistical significance for tumor size comparison (p <0.001) and nodal status comparison (p=0.002). ANOVA test did not show any statistical significance. Tukey\'s HSD posthoc test showed statistical significance (p=0.034) for N0 and N1 status. The highest concordance was shown by N0 and N1 followed by N2b.
CONCLUSIONS: Preoperative radiological and clinical assessments are essential for deciding on a patient\'s course of treatment. However, not all patients may require radiographs to determine tumor size or nodal status assessment. Accurate diagnosis is vital for the treatment planning of OSCC.