Eficacia do exame clinico e tomografia computadorizada na detecção de metastases linfonodais e da linfocintilografia na avaliação da drenagem linfatica em carcinoma espinocelular de boca e orofaringe

AUTOR(ES)
DATA DE PUBLICAÇÃO

2001

RESUMO

Clinical examination alone is not enough to establish the true extenuation of local involvement and regional metastases in oral and oropharyngeal carcinomas. The objectives of this work were to evaluate the sensitivity and specificity of computed tomography (CT) to determine regional metastases, and to verify the migration of 99mTc-Dextran by Iymphoscintigraphy to Iymph nodes in 48 patients with carcinoma of the mouth and oropharynx. The sensitivity of homolateral clinical examination and CT were 80% and 56%, while the contralateral were 66% and 16% respectively. The corresponding specificity for clinical examination and CT were 70% and 74% for homolaterallymph nodes, and 100% and 90% for contralateral, respectively. Considering only the 21 cases clinically staged NO,the sensitivity and specificity for examination CT homolateral was 16% and 73%, while the contralateral was 0% and 90% respectively. Lymphatic drainage of 99mTc-Dextranwas observed in 31 of the 48 cases studied, and some factors were considered as relevant. Tumours involving the floor of the mouth favoured a bilateral drainage, while those in the lateral border of the tongue and alveolar ridge tended to be homolateral. Large tumours (>3,5cm) favoured a bilateral or no migration, while those staged T1 e T2 most of the times migrated homolateraly. Lymphoscintigraphy tended to be negative or bilateral in cases of metastases confirmed microscopically. According to these results clinical examination was more efficiente than CT to identify neck involvement in oral and oropharyngeal carcinomas. Lymphoscitigraphic studies indicated that site and size of tumor as well as cervical metastases seem to be relevant to determine homolateral, bilateral or no migration of the 99mTc- Dextran. It is well accepted that Iymphatic drainage of the head and neck region is complex, and further studies are necessary before Iymphoscintigraphy is routinely used in the management of carcinomas of the mouth and oropharynx.

ASSUNTO(S)

pescoço metastase boca - cancer

ACESSO AO ARTIGO

Documentos Relacionados