Vol - 25, Issue - 3
About the Journal
[This article belongs to Volume - 25, Issue - 3]
International Medical Journal
Journal ID : IMJ-27-02-2020-293
Total View : 112

Abstract : Nodal metastasis is fairly common in Oral Squamous Cell Carcinoma and is hard to detect on physical examination. Thus, a cheap and reliable method for detection of lymph node metastasis is required. The objective of current study was to evaluate the sensitivity, specificity and diagnostic accuracy of contrast enhanced computed tomography (CECT) in detecting nodal metastasis in oral squamous cell carcinoma taking histopathology as gold standard. This cross sectional study comprised of n=125 diagnosed cases of oral squamous cell carcinoma. Preoperative CECT was done in each patient. Lymph nodes showing one or more features on CECT scan including ill-defined irregular bordered mass, non-enhancing mass in the nodal area greater than 1.5 cm for sub-mandibular & jugulodigastric nodes, greater than 0.8cm for retropharyngeal nodes, greater than 1.0 cm for all other nodes, grouping of 3 or more nodes in 6-15 mm area, central necrosis evidence with decrease density and/or dirty fat appearance with extra nodal spread were considered positive. At surgery lymph nodes were removed and diagnosed for oral squamous cell carcinoma metastasis on histopathology. Topographical correlation between dissected nodes and CECT scans was performed. Out of n=125 patients, n=89 (71.2%) patients were males and n=36 (28.8%) patients were females. The male to female ratio was 2.5:1. Mean age of the patients was found to be 53.61 ±16.72. Tongue was found to be the most common site of involvement with n=34 (27.2%) cases followed by buccal mucosa n=27 (21.6%) cases. It was found that the overall sensitivity of CECT scan was 77.97%, specificity 68.18%, positive predictive value (PPV) 68.66%, negative predictive value (NPV) 77.59% and the diagnostic accuracy of CECT scan was 72.8% taking histopathology as gold standard. CECT scan was found to have acceptable diagnostic accuracy and can be a helpful tool in detecting lymph node metastasis in Oral Squamous Cell Carcinoma

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