口腔鳞状细胞癌淋巴结特征与结节外扩展的相关性

IF 1.8 Q2 OTORHINOLARYNGOLOGY OTO Open Pub Date : 2024-10-17 eCollection Date: 2024-10-01 DOI:10.1002/oto2.70032
Piper A Wenzel, Steven L Van Meeteren, Nitin A Pagedar, Marisa R Buchakjian
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引用次数: 0

摘要

目的:确定淋巴结特征与结外扩展(ENE)之间的相关性:确定淋巴结特征与结外扩展(ENE)之间的相关性:研究地点: 三级医疗中心三级医疗中心:纳入2004年至2018年因口腔鳞状细胞癌接受颈部清扫术的患者,起始样本为496例。主要结果为至少1个淋巴结的ENE。其他变量包括解剖结节数、阳性结节级别、阳性淋巴结比率(LNR)以及转移性沉积物和ENE病灶的直径。进行了单变量和多变量二元逻辑回归分析,以确定所含变量与 ENE 之间的相关性:在 496 例患者中,233 例有结节转移(47.0%)。共切除 13,814 个结节,其中 714 个(5.2%)含有转移灶。在阳性结节中,28.0%有ENE,47.2%没有ENE,24.8%不详。ENE的平均直径为5.1毫米(SD,9.9)。单变量逻辑回归分析显示,同侧颈部 LNR 每增加 0.1 个单位(几率比 [OR] 1.16,95% 置信区间 [CI] 1.02-1.32,P = .02),转移性沉积物大小每增加 1 毫米(OR 1.在多变量逻辑回归分析中,转移性沉积物的大小(OR 1.06,CI 1.03-1.08,P = .02)和 N 级(P = .0003)与 ENE 显著相关:转移灶大小是ENE的独立预测因素,这表明随着转移灶大小的增加,通过囊膜扩展的几率也会增加。这可能是由于胶囊随着沉积物的增长而变薄,也可能是由于侵袭性疾病的侵袭性。
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Correlation of Lymph Node Characteristics and Extranodal Extension in Oral Cavity Squamous Cell Carcinoma.

Objective: Identify correlations between lymph node characteristics and extranodal extension (ENE).

Study design: Retrospective chart review.

Setting: Tertiary care center.

Methods: Patients who underwent neck dissection for oral cavity squamous cell carcinoma from 2004 to 2018 were included, with a starting sample of 496. The primary outcome was ENE in at least 1 lymph node. Additional variables included number of dissected nodes, positive nodes by level, positive lymph node ratio (LNR), and diameter of metastatic deposit and ENE focus. Univariate and multivariate binary logistic regression analyses were performed to determine correlations between included variables and ENE.

Results: Of the 496 patients, 233 had nodal metastasis (47.0%). 13,814 nodes were removed, with 714 (5.2%) containing metastasis. Of the positive nodes, 28.0% had ENE, 47.2% did not have ENE, and 24.8% were unknown. The mean ENE diameter was 5.1 mm (SD, 9.9). On univariate logistic regression analysis, ipsilateral neck LNR per 0.1 unit increase (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02-1.32, P = .02), metastatic deposit size per 1 mm increase (OR 1.06, CI 1.04-1.08, P < .0001), and clinical T- (P = .02) and N-class (P = .0003) significantly correlated with ENE. On multivariate logistic regression analysis, size of metastatic deposit (OR 1.06, CI 1.03-1.08, P < .0001) remained significantly correlated with ENE.

Conclusion: Controlling for confounding variables, size of metastatic deposit was an independent predictor of ENE, suggesting that as the metastatic deposit size increases, the odds of extension through the capsule also increases. This may be due to capsule thinning as the deposit grows or could represent the invasive nature of aggressive disease.

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来源期刊
OTO Open
OTO Open Medicine-Surgery
CiteScore
2.70
自引率
0.00%
发文量
115
审稿时长
15 weeks
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