舌癌後発頸部リンパ節転移例におけるCT値の検討

櫛橋 幸民, 池田 賢一郎, 江川 峻哉, 平野 康次郎, 洲崎 勲夫, 水吉 朋美, 北嶋 達也, 安藤 いづみ, 小林 一女, 嶋根 俊和

doi:10.5631/jibirin.112.519

<p>Tongue cancer, the most common type of oral cancer, is a disease that is frequently encountered by head and neck surgeons in daily medical practice. Approximately 20% to 40% of patients with early tongue cancer (T1/T2 tumors) reportedly have latent lymph node metastases, even though clinically, these patients are staged as N0. Although the indications for prophylactic neck dissection are controversial, it is extremely important to consider the methods to control delayed cervical lymph node metastasis. Of 46 patients with early tongue cancer, 10 patients with delayed cervical lymph node metastasis were enrolled in this study. Lymph nodes which later turned out to be malignant and also normal lymph nodes in both the affected and unaffected areas were scanned by computed tomography (CT) at the initial visit. The CT values were calculated, and the results were compared in order to examine whether or not measurement of the CT values of the lymph nodes at the initial visit might be useful in screening for delayed cervical lymph node metastasis. Our findings revealed that the CT values of the lymph nodes in patients with secondary cervical lymph node metastasis were statiscally significantly lower as compared to those in the patients without lymph node metastases. Therefore, in the case of low CT values, the affected/unaffected lymph nodes on the CT images of in patients with clinical N0 may be occult metastatic lymph nodes. Salvage neck dissection may later become necessary in these patients if they develop secondary cervical lymph node metastasis.</p>

舌癌後発頸部リンパ節転移例におけるCT値の検討

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