Predictive factors for malignant neoplasms veiled in deep neck infections

Abstract

Background: Malignant neoplasms (MNs) in the head and neck are occasionally hidden in deep neck infections (DNIs) that require emergency treatment, which potentially leads to delayed diagnosis of MNs.

Objectives: This study aimed to identify predictive factors that can prevent delays in diagnosing MNs in patients with DNIs.

Methods: We retrospectively analysed data from 83 patients admitted to our hospital who were diagnosed with DNIs.

Results: Four patients (4.8%) had DNIs veiling MNs in the head and neck. Statistical analyses revealed a significant association (p = .0481) of platelet to albumin ratio (PAR; ≥ 98.9 × 10³) with hidden MNs in DNIs. Furthermore, concomitant cervical lymphadenopathy, especially multiple lymphadenopathies and excluding abscesses, was higher in patients with DNIs veiling MNs (p = .0142 and p = .0023, respectively).

Conclusions and Significance: The PAR, which can be easily measured and readily detected, was a potential predictive factor. Moreover, performing fine-needle aspiration for lymphadenopathies could help diagnose hidden MNs in DNIs.

Chinese Abstract

背景：头部和颈部的恶性肿瘤（MN）偶尔隐藏在颈部深部感染（DNI）。颈部深部感染需要紧急治疗, 这可能导致MN的延迟诊断。

目的：本研究旨在确定可以防止DNI 患者的MN诊断延误的预测因素。

方法：我们回顾性分析了 83 例入住我院的被诊断出患有 DNI的患者的数据。

结果：4 名患者 (4.8%) 有 DNI 掩盖头部和颈部恶性肿瘤 。统计分析显示血小板与白蛋白比率（PAR；≥98.9x 10³)与隐藏于DNI 的 MN显著相关（p = .0481）。此外, 伴有颈部淋巴结肿大的患者, 尤其是多发淋巴结肿大和不包括脓肿, 患有隐藏于DNI 的 MN的比率较高（分别为 p = .0142 和 p = .0023）。

结论和意义：PAR是一种潜在的预测因素, 它可以很容易地测量和检测到。此外, 淋巴结病的细针抽吸有助于诊断 DNI 中隐藏的 MN。

Keywords:

• Deep neck infection
• malignant neoplasms in head and neck
• platelet to albumin ratio
• cervical lymphadenopathy

Acknowledgments

The authors thank Editage (www.editage.com) for English language editing.

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

This work was supported by the Grant-in-Aid for Young Scientists [M.P.S, grant number 19K18824].