Value of computed tomography for evaluating the subglottis in laryngeal and hypopharyngeal squamous cell carcinoma.
OBJECTIVE
Subglottic involvement in squamous cell carcinoma is a determining factor for contraindicating conservative partial surgery. The subglottis is easily identified by axial computed tomography sections. The present study aimed to evaluate the occurrence of false-negative and false-positive results, and the overall accuracy of staging by computed tomography, in order to detect the involvement of the subglottic laryngeal compartment, in cases of laryngeal and hypopharyngeal squamous cell carcinoma.


METHODS
Retrospective, non-randomized study of patients treated at Hospital Heliópolis, São Paulo, Brazil.


METHODS
Computed tomography scans were performed on third-generation equipment with 5-mm slice thickness. Afterwards, all patients underwent surgical and anatomopathological examinations as the gold standard procedures.


RESULTS
Among 60 patients, 14 were diagnosed with subglottic extension by surgical and histopathological examination. There were three false-negative and no false-positive results from computed tomography scans. The sensitivity and negative predictive value were 100.0%. Accuracy was 95.0%, specificity was 93.5% and positive predictive value was 82.4%.


CONCLUSIONS
Computed tomography could serve as a powerful auxiliary method for staging laryngeal and hypopharyngeal cancer. However, precautions should be taken in analyzing computed tomography scan data, because vegetating lesions may also be projected into the subglottic compartment, without real involvement of the subglottis, which may cause a false-positive result.
de Souza
Ricardo Pires
RP
Department of Head and Neck Surgery, Hospital Heliópolis, São Paulo, Brazil. ricapires@ig.com.br
de Barros
Nestor
N
Paes Junior
Ademar José de Oliveira
AJ
Tornin
Olger de Souza
Ode S
Rapoport
Abrão
A
Cerri
Giovanni Guido
GG
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D005260:Female; D005931:Glottis / Q000000981:diagnostic imaging*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging*; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed