Assessment of Cervical Lymph Nodes in Squamous Cell Carcinoma of the Head and Neck
- *Corresponding Author:
- Magdy Eisa Saafan
Department of Otolaryngology and Head & Neck Surgery
Tanta Faculty of Medicine and University Hospitals
61 Kafr Esam Street, El Nadi Square, Tanta, Egypt
E-mail: [email protected]
Received date: May 12, 2013; Accepted date: August 27, 2013; Published date: September 07, 2013
Citation: Saafan ME, Elguindy AS, Abdel–Aziz MF, Abdel-Rahman Younes A, Albirmawy OA, et al. (2013) Assessment of Cervical Lymph Nodes in Squamous Cell Carcinoma of the Head and Neck. Surgery Curr Res 3:145. doi:10.4172/2161-1076.1000145
Copyright: © 2013 Saafan ME, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: The most important prognostic factor in squamous cell carcinoma of the head and neck is the presence or absence of clinically involved neck nodes. The presence of metastases in a lymph node is said to reduce the 5-years survival rate by about 50%. The appropriate diagnosis of the presence of metastatic node is very important for the management of squamous cell carcinoma of the head and neck. The aim of this work is to study the status of cervical lymph nodes in known cases of squamous cell carcinoma in the head and neck and their relation to the primary site.
Methods: This study was carried out on 100 consecutive patients with a histologically proven non-cutaneous Head and Neck Squamous Cell Carcinoma (HNSCC). Every patient was subjected to clinical examination for cervical lymph nodes, CT scan on the neck with intravenous contrast and gray scale ultrasound scanning on the neck.
Results: Clinical palpation for cervical lymph nodes had a sensitivity of 71.43%, specificity 75.86% and accuracy 72.7%. CT scan was better than clinical palpation. The sensitivity for CT was 82.9%, while the specificity was 89.66% and the accuracy was 84.85%. Ultrasound scanning was found to be the best modality in assessment of metastases in cervical lymph nodes. The sensitivity was 97.1%, the specificity was 93% and the accuracy was 95.96%. The positive predictive value for Ultrasound scanning was 97.1% and the negative predictive value was 93%.
Conclusion: CT and ultrasound scanning increase the accuracy of lymph node detection. Although CT is better than clinical palpation, it is also considered inferior to ultrasound scanning in this aspect. Besides, ultrasound scanning is cheaper and with no hazards of radiation exposure.