Clinical Analysis of Hemodynamic Change Over the Facial Artery in Oral Squamous Cell Carcinoma

口腔鱗狀上皮細胞癌患者顏面動脈血行動力學差異性的臨床分析

陳韋至(Wei-Chih Chen) ； 林偉哲(Wei-Che Lin) ； 蔡明憲(Ming-Hsien Tsai) ； 陳秀玲(Hsiu-Ling Chen) ； 簡志彥(Chih-Yen Chien)

《台灣耳鼻喉頭頸外科雜誌》 53卷4期 (2018/12) Pp. 149-157

https://doi.org/10.6286/jtohns.201812_53(4).149

摘要

BACKGROUND: The aim of this study is to investigate the relationship between hemodynamic status of the facial artery and clinical outcome in oral squamous cell carcinoma (OSCC) patients by color Doppler sonography. METHOD: A total of 39 newly diagnosed OSCC patients were enrolled prospectively. The study set consisted of 39 facial arteries ipsilateral to the tumor and the contralateral facial arteries were included as controls. All sonographic indices of bilateral facial arteries were measured by color Doppler sonography before treatment. The relationship between sonographic indices and clinical outcome was analyzed. RESULT: Our results showed a significant increase of flow diameter and flow velocity ipsilateral to the tumor. The differences of flow diameter and flow velocity were significantly higher in patients with advanced T and N classifications. A significant lower overall survival rate was found in patients with greater differences of flow diameter, flow velocity and resistive index (RI). In Cox regression analysis, the patients with greater difference of RI and positive nodal metastasis had worse prognosis. CONCLUSION: This study demonstrated the divergent hemodynamic status of bilateral facial arteries in OSCC by color Doppler sonography. The hemodynamic difference of RI could serve as a prognostic predictor in patients with OSCC.

關鍵字

resistive index ； pulsatility index ； color Doppler sonography ； feeding vessel ； angiogenesis

並列摘要

背景：一般而言，惡性腫瘤會刺激周邊的組織血管新生以供應腫瘤細胞生長；理論上，此變化會造成其餵養血管的血流量增加及血行動力學上的變化。本研究利用都卜勒超音波探討口腔癌患者腫瘤側顏面動脈的血行變化並分析其與預後的相關性。方法：本研究以前瞻性方式招募共39名新發的口腔癌患者，所有患者在治療前皆接受都卜勒超音波檢查並記錄受試者兩側的顏面動脈血流變化。我們將腫瘤側的顏面動脈做爲實驗組，而另一側的顏面動脈做為對照組，後續比較兩組的差異比值並分析此差異性和臨床特徵及預後的相關性。結果：本研究發現在腫瘤側顏面動脈的血管直徑及血流速度有明顯的增加。在較高原發腫瘤分期（T classification）及淋巴轉移的患者，其實驗側顏面動脈的血管直徑及血流速度有較明顯的增加。而與對照側相比，若實驗側顏面動脈的血管直徑、血流速度有較明顯增加及阻力係數（resistive index；RI）有較明顯減少者，其5年存活率較差。在多變數分析發現，頸部淋巴轉移及腫瘤側顏面動脈阻力係數減少者有較差的預後。結論：本研究發現在口腔癌患者，腫瘤側及非腫瘤側顏面動脈的血行動力學上有明顯的差異；而使用都卜勒超音波檢查所測得的阻力係數和病患的預後有較明顯的相關性。

並列關鍵字

resistive index ； pulsatility index ； color Doppler sonography ； feeding vessel ； angiogenesis（阻力係數 ； 脈動係數 ； 彩色都卜勒超音波 ； 餵養血管 ； 血管新生）