Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Mediastinal Lymph Node Metastasis from Head and Neck Cancer: Predictive Factors and Imaging Features

두경부암의 종격동 림프절 전이: 예측인자 및 영상 소견

  • Il Kwon Ko (Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine) ;
  • Dae Young Yoon (Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine) ;
  • Sora Baek (Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine) ;
  • Ji Hyun Hong (Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine) ;
  • Eun Joo Yun (Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine) ;
  • In Jae Lee (Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine)
  • 고일권 (한림대학교 의과대학 강동성심병원 영상의학과) ;
  • 윤대영 (한림대학교 의과대학 강동성심병원 영상의학과) ;
  • 백소라 (한림대학교 의과대학 강동성심병원 영상의학과) ;
  • 홍지현 (한림대학교 의과대학 강동성심병원 영상의학과) ;
  • 윤은주 (한림대학교 의과대학 강동성심병원 영상의학과) ;
  • 이인재 (한림대학교 의과대학 한림대학교성심병원 영상의학과)
  • Received : 2020.12.15
  • Accepted : 2021.01.26
  • Published : 2021.09.01
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Abstract

Purpose To assess the predictive factors and describe the imaging features of mediastinal lymph node (MLN) metastases in patients with head and neck cancer. Materials and Methods We compared the clinical features and disease characteristics (sex, age, site of primary tumor, histologic type, history of prior treatments, TNM stages, and metastasis in cervical LNs) of patients with head and neck cancers between the MLN metastasis and no MLN metastasis groups. We also evaluated the chest CT (distribution and maximum dimension of the largest LN) and PET/CT (maximum standardized uptake value) features of MLN metastases based on the MLN classification. Results Of the 470 patients with head and neck cancer, 55 (11.7%) had MLN metastasis, involving 150 mediastinal stations. Hypopharynx cancer, recurrent tumor, T4 stage, N2/N3 stages, and M1 stage were found to be significant predicting factors for MLN metastasis. The most common location of MLN metastasis was ipsilateral station 2 (upper paratracheal LNs, 36.4%), followed by ipsilateral station 11 (interlobar LNs, 27.3%) and ipsilateral station 10 (hilar LNs, 25.5%). Conclusion Metastasis to MLNs should be considered in patients with head and neck cancer, especially in cases that are associated with a hypopharyngeal cancer, recurrent tumor, and high TNM stages.

목적 본 연구의 목적은 두경부암의 종격동 림프절 전이의 예측인자와 영상 소견을 알아보고자 함이다. 대상과 방법 이 연구에서 저자들은 두경부암 환자 중에서 종격동 림프절 전이그룹과 비전이 그룹 사이의 임상 소견 및 질병의 특성(성별, 연령, 원발성 종양 부위, 조직학적 유형, 악성종양에 대한 이전 치료이력, T-, N- 및 M- 단계, 경부 림프절 전이) 들을 비교하였다. 또한 저자들은 전이그룹에서 종격동 림프절 분류에 따라 림프절 전이의 흉부 전산화단층촬영(전이분포와 림프절 최대직경) 및 양전자방출단층촬영/전산화단층촬영(최대 표준섭취계수)의 소견을 평가하였다. 결과 두경부암 환자 470명 중 55명(11.7%)에서 150개의 종격동 station을 포함하는 종격동 림프절 전이가 발견되었다. 하인두암, 재발한 종양, T4, N2/N3, 및 M1 단계는 종격동 림프절 전이의 의미 있는 예측인자로 평가되었다. 종격동 림프절 전이의 가장 흔한 위치는 일측 station 2 (상부기관주위 림프절, 36.4%), 일측 station 11 (엽간 림프절, 27.3%), 일측 station 10(폐문 림프절, 25.5%) 순이었다. 결론 하인두암, 재발성 종양 및 높은 TNM 단계인 경우, 두경부암의 종격동 림프절 전이 가능성을 고려하여야 한다.

Keywords

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