Diagnostic accuracy of CT scan for detection of cervical lymph node metastasis in oral squamous cell carcinoma in comparison with histopathological analysis after neck dissection

  • Hassan Mirmohammad Sadeghi Department of Oral & Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences,Tehran, Iran.
  • Alireza Pournabi Department of Oral & Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences,Tehran, Iran.
  • Mahshid Namdari Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Keywords: carcinoma, lymph nodes, neck dissection, pathology, squamous cell of head and neck

Abstract

Objectives Presence/absence of cervical lymph node metastasis plays a critical role in prognosis and survival of patients with oral squamous
cell carcinoma (SCC). This study was designed to assess the diagnostic accuracy of computed tomography (CT) scan for detection of
cervical lymph node metastasis in oral SCC in comparison with histopathological analysis after neck dissection.
Methods In this retrospective cross-sectional study, pathology and CT reports of 50 patients with oral SCC were retrieved from the archives
of Taleghani and Shariati Hospitals and data regarding the site of involvement, lymph node metastasis, level of cervical involvement and
size of involved lymph node were retrieved from patient files. The results of CT scan and pathology reports were compared and the
accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CT scan were calculated compared
to the gold standard (pathology report). Basic statistics was meed for analyz the data.
Results The sensitivity of CT scan for detection of metastatic cervical lymph nodes was 69.23% compared to the pathology report (gold
standard). The specificity, PPV and NPV were 27.02%, 25% and 71.42%, respectively. The diagnostic accuracy of CT scan was 38%.
Conclusion Based on the results, CT scan is not reliable for detection of metastatic cervical lymph nodes in oral SCC, and more advanced
techniques may be indicated for assessment of cervical lymph node involvement and deciding on the most efficient surgical approach in
patients with oral SCC.
 

Published
2016-06-06
Section
Articles