ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
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ORIGINAL RESEARCH

The Relation Between Positron Emission Tomography Findings and Histopathological Findings of Surgical Samples in Advanced Stage Laryngeal Cancers
İleri Evre Larinks Kanserlerinde Pozitron Emisyon Tomografi Bulgularının Ameliyat Materyallerindeki Histopatolojik Bulgularla İlişkisi
Received Date : 27 Feb 2022
Accepted Date : 15 Sep 2022
Available Online : 20 Sep 2022
Doi: 10.24179/kbbbbc.2022-89290 - Makale Dili: TR
KBB ve BBC Dergisi. 2022;30(4):173-8
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Our aim is to investigate the relation between preoperative positron emission tomography/computed tomography (PET/CT) and histopathological findings in advanced-stage laryngeal cancers (ASLC). Also, another aim is to discuss importance of PET/CT in management of patients by investigating the need for postoperative radiotherapy/chemotherapy (RT/CT) with preoperative PET/CT findings. Material and Methods: Between 2010 and 2020 years, patients diagnosed with laryngeal squamous cell carcinoma and undergoing total laryngectomy were retrospectively reviewed from medical charts of the patients. Of 70 patients, 36 patients with ASLC, undergoing bilateral neck dissection and with preoperative PET/CT results were included this study. We investigated correlation between maximum standard uptake values (SUVmax) in preoperative PET/CT and histopathological finding, including perineural invasion, lymphovascular invasion, metastasis to lymph node (LN) and extracapsular spread (ECS). Results: Four female and 32 male patients were included this study. The mean age was 62.02±11.40 years. Seventeen (47%) had T3 and 19 (53%) patients had T4 tumor. There was a statistically significant relation between SUVmax value of LN and histopathological findings, metastasis to LN, the number of metastatic LNs and ECS. Cut-off value of SUVmax for metastatic LN in preoperative PET/CT was 6.36 (a sensitivity of 86.4% and specificity of 78.6%) and cut-off value of SUVmax for ECS was 9 (a sensitivity of 76.9% and specificity of 78.3%). Conclusion: SUVmax values over 6.36 may be correlated with metastasis to LN while those over 9.0 are correlated with ECS. These results may be helpful preoperatively in management of the disease and counseling of patients and their relatives in adjuvant RT/CT.
ÖZET
Amaç: Amacımız ileri evre larinks kanserlerinde preoperatifpozitron emisyon tomografi/bilgisayarlı tomografi (PET/BT) bulguları ve histopatolojik bulgular arasındaki ilişkiyi araştırmaktır. Ayrıca bir diğer amacımız, preoperatif PET/BT bulguları ile postoperatif radyoterapi/ kemoterapi (RT/KT) ihtiyacını araştırarak hasta yönetiminde PET/BT’nin önemini tartışmaktır. Gereç ve Yöntemler: 2010 ve 2020 yılları arasında larinks yassı hücreli karsinomu tanısı alan ve total larenjektomi yapılan hastalar retrospektif olarak dosya kayıtlarından incelendi. Yetmiş hasta arasından, ileri evre larinks kanseri olan, bilateral boyun diseksiyonu yapılan ve preoperatif PET/BT sonuçları mevcut olan 36 hasta bu çalışmaya dâhil edildi. Preoperatif PET/BT’de “maksimum standardized uptake value (SUVmax)” ve histopatolojik bulgular olan perinöral invazyon, lenfovasküler invazyon, lenf nodu metastazı ve ekstrakapsüler yayılım arasındaki ilişkiyi araştırdık. Bulgular: Dört kadın ve 32 erkek hasta bu çalışmaya dâhil edildi. Ortalama yaş 62,02±11,40 idi. On yedi (%47) hastada T3 tümörü ve 19 (%53) hastada T4 tümörü vardı. Lenf nodu SUVmax değeri ve histopatolojik bulgulardan lenf nodu metastazı, metastatik lenf nodu sayısı ve ekstrakapsüler yayılım arasında istatistiksel olarak anlamlı bir ilişki vardı. Preoperatif PET/BT’de metastatik lenf nodu için SUVmax sınır değeri 6,36 (duyarlılık %86,4 ve özgüllük %78,6) ve ekstrakapsüler yayılım için SUVmax sınır değeri 9,0 (duyarlılık %76,9 ve özgüllük %78,3) idi. Sonuç: 6,36’nın SUVmax değerleri lenf nodu metastazı ile ilişkiliyken 9’un üzerindeki değerler ekstrakapsüler yayılım ile ilişkili olabilir. Bu sonuçlar, adjuvan RT/KT açısından preoperatif olarak hasta ve yakınlarını bilgilendirmede ve hastalığın yönetiminde yardımcı olabilirler.
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