Diagnosis and prognosis of cervical lymph node metastases of squamous cell carcino-ma of unknown primary site
10.3969/j.issn.1000-8179.2019.07.235
- VernacularTitle:原发病灶不明颈淋巴结转移鳞癌的诊断和预后*
- Author:
Mengqian ZHOU
1
;
Lu ZHANG
;
Yansheng WU
;
Yuansheng DUAN
;
Xudong WANG
Author Information
1. 天津医科大学肿瘤医院颌面耳鼻喉肿瘤科
- Keywords:
cervical lymph node metastasis;
diagnosis,primary lesion,prognosis,squamous cell carcinoma
- From:
Chinese Journal of Clinical Oncology
2019;46(7):346-350
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the characteristics, diagnosis, primary detection, and prognosis of cervical lymph node metastases of squamous cell carcinoma of unknown primary site (SCCUP). Methods: This study retrospectively analyzed the clinical features and follow-up data of 262 patients with SCCUP. The Chi-square test were used to analyze the clinical performances, characteristics of pri-mary lesions, and sensitivity and specificity of examinations to identify original lesions. Factors related to the overall survival (OS) and progression-free survival (PFS) were also analyzed. Results: The 262 patients with SCCUP comprised more men, with a median age of 57 years. At the follow-up, 70 patients were diagnosed with primary lesions (26.7%), and the detection rates of primary lymph nodes in those who were male (30.1%), with a single lesion site (31%), and with levelⅣdisease (39.3%) were higher than those in patients who were female (17.4%), with multiple lesion sites (18.7%), and with levelⅡ/Ⅲdisease (20.8%). Compared with traditional imaging examinations, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) had higher sensitivity and speci-ficity in detecting the primary tumor. Survival analysis showed that distant metastasis was an independent risk factor affecting OS and PFS, and the effect of N stage on PFS was statistically significant. Conclusions: In SCCUP patients, the proportion of patients who were male, with a single lesion site, and with cervicalⅣlymph node metastasis had higher rates of detection of the primary sites. PET/CT examination is important for the diagnosis of SCCUP, as well as the detection of primary lesions. Advanced N stage and distant metasta-sis indicated poor prognosis.
