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
Harun GÜRa, Onur İSMİa, Zehra Pınar KOÇb, Kemal Koray BALa, Yusuf VAYISOĞLUa, Kemal GÖRÜRa, Cengiz ÖZCANa
aMersin Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları ABD, Mersin, Türkiye
bMersin Üniversitesi Tıp Fakültesi, Nükleer Tıp ABD, Mersin, Türkiye
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.
Keywords: Laryngeal neoplasms; positron-emission tomography; neoplasm metastasis (tumor metastasis); neck; lymph nodes
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.
Anahtar Kelimeler: Larinks neoplazileri; pozitron-emisyon tomografi; tümör metastazı; boyun; lenf nodları
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