Diagnosis plays a key role in overall patient assessment and accurate staging
of the malignancy. Diagnosis is the starting point to choose treatment strategies for the
disease, as well as the basis upon which therapy success, prognosis and the patient’s
quality of life will vary. Considering a high level of clinical suspicion of any mucosal
alteration or laterocervical swelling is important until medical examinations provide
evidence of the contrary. Diagnosis investigation continues with the search, among data
collected on the patient's history, of objective signs on which clinical suspicions will
focus through further medical and instrumental examinations. Imaging techniques that
can be used are ultrasound scan, computerised tomography, magnetic resonance and, in
the most complex cases, positron emission computerised tomography. Ultrasonography
is the most commonly used imaging technique for head and neck mass, especially for
the assessment of lymph nodes, thyroid glands and salivary glands. Magnetic resonance
is also considered an important examination in the diagnosis of head and neck tumours,
especially for lesions involving the oral cavity, oropharynx, nasopharynx and larynx.
Computerised tomography (CT) scan is especially useful when assessing the skull base
involvement and the morphology of laryngeal malignancies, for example when the
tumour extends over the perichondrium of cartilage structures, as well as when
assessing function, i.e. evaluating the degree of chordal motility. In head and neck
cancers (HNC), predictive factors namely biological characteristics that can be used to
predict tumor response to a specific treatment, are currently remarkably lacking.
Conversely, some bio-molecular parameters are recognized as prognostic factors of the
disease, since they indicate tumor characteristics that inform about cancer outcome, independently of treatment the patients will undergo. The most prominent prognostic
factor for head and neck cancers is viral etiology, specifically HPV-mediated disease
for oropharyngeal carcinomas and EBV-mediated disease for nasopharyngeal
carcinoma.
Keywords: Biomarkers, Diagnostic tool, Head and neck cancer, Investigation,
Imaging, TNM classification.
