VEFA KINIŞ, Musa ÖZBAY, Aylin GÜL, Mehmet AKDAĞ, Fazi Emre ÖZKURT, Beyhan YILMAZ, Engin ŞENGÜL, İsmail TOPÇU

Preoperatif larinks kanserlerinin değerlendirilmesi ve tedavi planlaması: BT ne kadar güvenilir?

ÖZET Amaç: Larinks kanserleri, erken evrede teşhis edilip tedavi edilirlerse potansiyel olarak tedavi edilebilir tümörlerdir. Başarılı bir preoperatif evreleme ve değerlendirme için klinik muayenenin yanında, bilgisayarlı tomografinin de oldukça önemli bir rolü vardır. Bu çalışmada, larinks kanserlerinin tümör evresini, prognozunu ve tedavi planlamasını etkileyen larinks alt bölgelerin değerlendirilmesinde bilgisayarlı tomografinin güvenilirliğini tespit etmeye çalıştık. Gereç ve Yöntem: Bu çalışma, Haziran 2007 ile Eylül 2012 tarihleri arasında KBB Hastalıkları Bölümünde yassı hücreli larinks kanseri nedeniyle ameliyat edilen 43 erkek hastanın retrospektif inceleme sonuçlarına göre yapılmıştır. Bulgular: Bilgisayarlı tomografinin ön komissür invazyonunu tespit etmede duyarlılığı, özgüllüğü, negatif-prediktif değeri, pozitif-prediktif değeri ve doğruluğu sırasıyla %60, %72.2, %75, %56.5 ve %65.1 şeklindeydi. Bilgisayarlı tomografinin tiroid kıkırdak invazyonunu tespit etmede duyarlılığı, özgüllüğü, negatif-prediktif değeri, pozitif-prediktif değeri ve doğruluğu sırasıyla %71.4, %86.6, %83.3, %68.4 ve %76.7 şeklindeydi. Bilgisayarlı tomografinin subglottik bölge invazyonunu tespit etmede duyarlılığı, özgüllüğü, negatif-prediktif değeri, pozitif-prediktif değeri ve doğruluğu sırasıyla %88.23, %92.59, %96.15, %93.59 ve %95.34 şeklindeydi. Sonuç: Derin larinks alt bölgelerinin değerlendirilmesinde bilgisayarlı tomografinin önemli bir rolü olmakla birlikte tek başına kullanıldığında yanlış evreleme ihtimali bulunmaktadır.

Preoperative Assessment and Therapy Planning of Laryngeal Cancers: How Reliable is the CT?

Preoperative Assessment and Therapy Planning of Laryngeal Cancers: How Reliable is the CT? Objective: Laryngeal cancers are potentially treatable malignancies on condition that the diagnosis is made and the treatment is started at an early phase. Computed tomography has a very important role in preoperative staging and evaluation of laryngeal cancer, beside clinical examination. In present study, we tried to determine the reliability of computed tomography in assessing the laryngeal regions which affect the tumour stage, prognosis and therapy planning. Material and Method: This retrospective study included 43 male patients who were operated at ENT department between June 2007 and September 2012 due to laryngeal squamous cell carcinoma. Results: The sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy ratios of computed tomography in detecting anterior commissure invasion were 60%, 72.2%, 75%, 56.5%, and 65.1%, respectively. The sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy ratios of computed tomography in detecting thyroid cartilage invasion were 71.42%, 86.66%, 83.33%, 68.42%, and 76.74%, respectively. The sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy ratios of computed tomography in detecting subglottic region invasion were 88.23%, 92.59%, 96.15%, 93.59% and 95.34%, respectively. Conclusion: Although, computed tomography plays a very important role in the evaluation of deep laryngeal structures, it also has a serious risk of wrong staging when used alone.

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