| Objective:There are many studies on the pre-operative diagnosis of cervical lymph node matastases of oral and maxillofacial malignancy in china and abroad,but there are few studies on the diagnosis of different pathogenic sites and different histopathological types in China.In this study,pre-operative physical palpation,MRI and PET/CT were performed on patients with oral and maxillofacial malignancy,and postoperative pathological results were used as the gold standard to compare the pre-operative diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the three examination methods.Methods:Retrospective analysis of the physical data of 86 patients who were diagnosed by postoperative pathological examination as oral and maxillofacial malignancy after surgical operation from January 2014 to December 2018.All patients underwent physical palpation,MRI and PET/CT of the cervical lymph nodes before surgery,and the diagnoses were recorded in detail,the postoperative pathological diagnosis was used as the reference standard to calculate the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the three examination methods.The results were compared byχ~2 test,and significance was set at P<0.05.Result:1.Comparison of the diagnostic results of PET/CT,MRI and physical palpation:the sensitivity of PET/CT,MRI and physical palpation were 79.5%,64.1%and43.6%.There was a significant difference between the sensitivity of PET/CT and physical palpation(P<0.05),and the other results showed no significant difference(P>0.05).2.Comparison of PET/CT,MRI and physical palpation of tongue cancer:the sensitivity of PET/CT,MRI and physical palpation were 91.7%,66.7%and 25.0%,the sensitivity of PET/CT and MRI was significantly different from physical palpation(P<0.05),the accuracy and negative predictive value between PET/CT and physical palpation were significantly different(P<0.05),and the other results showed no significant difference(P>0.05).3.Comparison of PET/CT,MRI and physical palpation in cases of buccal carcinoma and gingival cancer:there was no significant difference among PET/CT,MRI and physical palpation(P>0.05).4.Comparison of PET/CT,MRI and physical palpation of squamous cell carcinoma:the sensitivity of PET/CT,MRI and physical palpation were 78.8%,60.6%and 39.4%,and the accuracy were 72.2%,68.1%and 63.9%,the sensitivity and accuracy of PET/CT and physical palpation were significantly different(P<0.05).5.Comparison of PET/CT,MRI and physical palpation of moderately differentiated squamous cell carcinoma:the sensitivity of PET/CT,MRI and physical palpation were 100.0%,60.0%and 63.9%,the sensitivity of PET/CT was significantly different from MRI and physical palpation(P<0.05),the negative predictive value between PET/CT and physical palpation was significantly different(P<0.05).6.Comparison of PET/CT,MRI and physical palpation in cases of highly differentiated and poorly differentiated squamous cell carcinoma:there was no significant difference among PET/CT,MRI and physical palpation(P>0.05).Conclusion:1.PET/CT has a better diagnostic accuracy than physical palpation in the pre-operative diagnosis of cervical lymph node metastases of oral and maxillofacial malignant tumor.2.PET/CT is more accurate than MRI and physical palpation in pre-operative diagnosis of cervical lymph node metastases of tongue cancer.3.PET/CT has a good pre-operative diagnostic effect on cervical lymph node metastasis of moderately differentiated and poorly differentiated squamous cell carcinoma,but a poor pre-operative diagnostic effect on highly differentiated squamous cell carcinoma. |
