Int J Stomatol

Int J Stomatol ›› 2021, Vol. 48 ›› Issue (3): 312-317.doi: 10.7518/gjkq.2021036

• Original Articles • Previous Articles     Next Articles

Correlation between the depth of invasion measured by magnetic resonance imaging and cervical lymph node metastasis in patients with tongue squamous cell carcinoma

Li Ming(),Yuan Zhenying,Nan Xinrong()   

  1. Dept. of Stomatology, The First Hospital of Shanxi Medical University, Taiyuan 030001, China
  • Received:2020-08-12 Revised:2021-01-22 Online:2021-05-01 Published:2021-05-14
  • Contact: Xinrong Nan E-mail:limingq248@163.com;xr-nan@sina.com
  • Supported by:
    Key Research and Development Plan of Shanxi Province(201803D31094)

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Abstract:

Objective The correlation between the depth of invasion (DOI) measured by magnetic resonance imaging (MRI) and cervical lymph node metastasis of stage cN0 tongue squamous cell carcinoma was analysed to determine whether the DOI measured by MRI could be used as an independent predictor of cervical lymph node metastasis in stage cN0 tongue squamous cell carcinoma. Methods A total of 61 patients with tongue squamous cell carcinoma were selected after screening using inclusion and exclusion criteria. The relationships between the DOI and other clinicopathological factors (age, tumour site, tumour T stage, tumour differentiation and nerve invasion) and cervical lymph node metastasis measured by MRI in included patients. Results Amongst the 61 patients, 19 (31%) were positive for postoperative pathological cervical lymph node metastasis (pN+) and 42 (69%) were negative for cervical lymph node metastasis (pN0). Single logistic regression showed that the DOI, T stage and nerve invasion factors measured by MRI were correlated with cervical lymph node metastasis in tongue squamous cell carcinoma (P<0.05). Multivariate logistic regression showed that the DOI measured by MRI was correlated with cervical lymph node metastasis (P<0.05). The mean DOI of the 19 pN+ patients measured by MRI was (13.2±4.3) mm, whereas that of the 42 pN0 patients was (9.1±4.5) mm. The difference was statistically significant (T=3.36, P=0.001). The receiver operating characteristic curve showed that the cut-off MRI DOI was 5.1 mm for predicting cervical lymph node metastasis in stage cN0 tongue squamous cell carcinoma. Conclusion The DOI measured by MRI is an independent factor in predicting cervical lymph node metastasis in stage cN0 tongue squamous cell carcinoma. When the DOI measured by MRI was greater than 5.1 mm, the risk of cervical lymph node metastasis increased in stage cN0 tongue squamous cell carcinoma.

Key words: tongue squamous cell carcinoma, depth of invasion, magnetic resonance imaging, cervical lymph node metastasis

CLC Number: 

  • R782

TrendMD: 

Fig 1

The schematic diagram of DOI measurement of tongue squamous cell carcinoma"

Tab 1

Univariate logistic regression of neck lymphatic metastasis of cN0 tongue squamous cell carci-noma"

因素 n 淋巴结阳性者 淋巴结阳性率/% P值
年龄/岁
>60 36 12 33 0.658
≤60 25 7 28
肿瘤部位
舌缘舌腹 51 15 29 0.376
舌背 10 4 40
T分期
T1 16 3 19 0.035
T2 27 7 26
T3 9 4 44
T4 9 5 56
DOI/mm
≤5 11 1 9 0.015
>5, ≤10 16 3 19
>10 34 15 44
肿瘤分化
高分化 36 11 31 0.509
中分化 17 4 24
低分化 8 4 50
神经侵犯
+ 12 7 58 0.023
- 49 12 24
脉管癌栓
+ 1 1 100
- 60 18 30

Tab 2

Multivariate logistic regression of neck lympha-tic metastasis of cN0 tongue squamous cell carcinoma"

因素 P值 OR值 OR值的95%CI
下限 上限
DOI/mm
≤5 0.027 0.028 0.001 0.661
>5, ≤10 0.042 0.184 0.036 0.939
>10 0.05
T分期
T1 0.211 5.221 0.393 69.387
T2 0.683 0.783 0.242 2.534
T3 0.839 0.892 0.294 2.702
T4 0.429
神经侵犯 0.137 0.467 0.171 1.274

Tab 3

The relationship between the MRI invasion depth and cervical lymph node metastasis"

DOI/mm 总数量 pN0组 pN+组
数量 百分比/% 数量 百分比/%
≤5.1 12 11 92 1 8
>5.1 49 31 63 18 37
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