Objective: To compare the clinical features and prognoses of patients with oropharyngeal or hypopharyngeal squamous cell carcinoma (SCC) with and without retropharyngeal lymph node metastases. Methods: PubMed, Cochrane, Web of Science, CNKI, VIP and Wanfang databases were searched for published literatures on retropharyngeal lymph node metastasis of oropharyngeal or hypopharyngeal squamous cell carcinoma (1900, 2021), and outcome indicators such as survival rate and related clinical features were extracted. The quality evaluation of the included literatures was carried out. RevMan 5.4 and Stata 16.0 software were used for data analysis. Results: A total of 18 literatures were included. Meta analysis showed that 3-year and 5-year survival rates and 5-year disease-specific survival rate of patients with oropharyngeal or hypopharyngeal squamous cell carcinoma with retropharyngeal lymph node metastases were lower than those without metastases, 46.1% vs. 53.0%, 40.8% vs. 62.5% and 35.9% vs. 53.1%, respectively, and the differences were statistically significant (OR values were 0.26, 0.38, 0.38, and 95%CI were 0.10-0.69, 0.28-0.51, 0.23-0.65, respectively, all P values<0.05). There were statistically significant differences in clinical stage (III-IV), T stage (T3+T4), N stage (N2), positive cervical lymph node metastases and number of lymph node metastases (≥3) between the two groups (OR values were 4.28, 2.20, 2.88, 10.83, 6.53, and 95%CI were 1.70-10.74, 1.35-3.58, 1.90-4.34, 3.57-32.95, 1.75-24.38, respectively, all P<0.05). The sensitivity and specificity of preoperative imaging for diagnosing retropharyngeal lymph nodes metastases were respectively 0.72 (95%CI=0.54-0.85) and 0.98 (95%CI=0.74-1.00), and the area under curve (AUC) of summary receiver operating characteristic curve (SROC) was 0.84 (95%CI=0.80-0.87). Conclusions: The survival rate of patients with oropharyngeal or hypopharyngeal squamous cell carcinoma with retropharyngeal lymph node metastasis is significantly reduced, the clinical stage and T stage are late, and the cervical lymph node metastasis rate is high. Retropharyngeal lymph node metastasis is more insidious, the sensitivity of preoperative imaging diagnosis is not high.
目的： 使用Meta分析的方法，比较咽后淋巴结转移和未转移的口咽和下咽鳞状细胞癌（简称鳞癌）患者的预后及临床特征。 方法： 检索PubMed、Cochrane、Web of Science、中国知网、维普、万方数据库中公开发表的研究口咽和下咽鳞癌咽后淋巴结转移的文献（1900—2021年），提取文献中生存率和相关临床特征等结局指标，对纳入文献进行质量评价，采用RevMan 5.4及Stata 16.0软件进行数据分析。 结果： 最终纳入文献18篇。Meta分析结果显示口咽和下咽鳞癌咽后淋巴结转移患者的3年生存率（46.1%）、5年生存率（40.8%）、5年疾病特异性生存率（35.9%）均低于未发生转移者（分别为53.0%、62.5%、53.1%），差异有统计学意义（OR值分别为0.26、0.38、0.38，95%CI分别为0.10~0.69、0.28~0.51、0.23~0.65，P值均<0.05）。咽后淋巴结转移组与未转移组在临床分期为Ⅲ-Ⅳ期、T3+T4期、N2期、颈部淋巴结转移阳性以及淋巴转移数目≥3上的差异均有统计学意义（OR值分别为4.28、2.20、2.88、10.83、6.53，95%CI分别为1.70~10.74、1.35~3.58、1.90~4.34、3.57~32.95、1.75~24.38，P值均<0.05）。术前影像诊断咽后淋巴结的灵敏度为0.72（95%CI为0.54~0.85），特异度为0.98（95%CI为0.74~1.00），综合受试者工作特征（summary receiver operating characteristic，SROC）曲线的曲线下面积（area under curve，AUC）为0.84（95%CI为0.80~0.87）。 结论： 口咽和下咽鳞癌发生咽后淋巴结转移者的生存率显著降低，临床分期和T分期均较晚，颈部淋巴结转移率较高。咽后淋巴结转移较为隐匿，术前影像诊断灵敏度不高。.