Comparison of diagnostic efficacy and establishment of predictive model between ultrasound and enhanced CT in cervical lymph node metastasis of head and neck squamous cell carcinoma

doi:10.19438/j.cjoms.2025.06.009

Abstract

Abstract: PURPOSE: To compare the diagnostic efficacy of ultrasound and enhanced CT in the diagnosis of cervical lymph node metastasis in patients with head and neck squamous cell carcinoma(HNSCC), and establish a predictive model to improve the accuracy of early diagnosis. METHODS: A total of 125 patients with primary HNSCC who underwent neck lymph node dissection at Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from November 2022 to April 2024 were selected. Their ultrasound and enhanced CT data, as well as information on primary lesion pathology and cervical lymph node metastasis, were collected and randomly divided into a modeling group and a validation group in a 7∶3 ratio. In the modeling phase, a multi-factor logistic regression model was used to screen for predictive factors of cervical lymph node metastasis, and a column chart was constructed based on these variables. The area under the ROC curve and calibration curve were used to evaluate the discrimination and calibration of the model. The clinical application value of the model was evaluated using clinical decision curves. RESULTS: The results of multiple logistic regression model showed that the maximum diameter of lymph nodes, the depth of primary lesion infiltration, the degree of differentiation, and the age of the patients had a significant impact on the diagnosis of cervical lymph node metastasis (P<0.05). Based on these risk factors, a risk column chart prediction model was established, and the area under the ROC curve and calibration curve showed good discrimination and accuracy of the model. Clinical decision curve analysis showed that the model has certain clinical practicality within a large threshold. CONCLUSIONS: Overall, ultrasound is superior to enhanced CT in the diagnosis of cervical lymph node metastasis in patients with head and neck squamous cell carcinoma. The column chart model of cervical lymph node metastasis constructed in this study has a good predictive effect and can provide reference for clinical prediction of lymph node metastasis in head and neck squamous cell carcinoma.

Key words: Head and neck squamous cell carcinoma, Ultrasonography, Enhanced CT, Cervical lymph node metastasis, Diagnostic model

CLC Number:

R739.8
R445

Shi Yanni, Yin Jianxin, Ling Xiao, Wang Hongwei, Wang Lei, Qin Xingjun. Comparison of diagnostic efficacy and establishment of predictive model between ultrasound and enhanced CT in cervical lymph node metastasis of head and neck squamous cell carcinoma[J]. China Journal of Oral and Maxillofacial Surgery, 2025, 23(6): 592-599.

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