超声引导下细针穿刺细胞学检查诊断不同大小颈部淋巴结

目的探讨超声引导下细针穿刺抽吸细胞学检查(US-FNAC)对不同大小颈部淋巴结的定性诊断价值。方法回顾性分析130例患者共142个颈部淋巴结的US-FNAC资料,并与术后病理检查或临床随访最终确诊结果对照。将142个淋巴结按其短径分为A组(5mm)、B组(5~10mm)及C组(10mm),进行统计学分析。结果 US-FNAC诊断阳性淋巴结65个(恶性58个,可疑恶性7个),阴性淋巴结77个(良性59个,不确定及不满意18个);经术后病理检查或临床随访最终确诊为恶性淋巴结70个,良性淋巴结72个。颈部淋巴结US-FNAC定性诊断敏感度、特异度、准确率、阳性预测值及阴性预测值分别为:A组,82.35%(14/17)、95.00%(19/20)、89.19%(33/37)、93.33%(14/15)、86.36%(19/22);B组,91.17%(31/34)、97.56%(40/41)、94.67%(71/75)、96.88%(31/32)、93.02%(40/43);C组,94.73%(18/19)、100%(11/11)、96.67%(29/30)、100%(18/18)、91.67%(11/12)。3组间敏感度、特异度、准确率、阳性预测值及阴性预测值差异均无统计学意义(P均0.05)。结论 US-FNAC为鉴别颈部淋巴结良恶性的有效手段,对不同大小的淋巴结均具有较高诊断效能。

Ultrasound-guided fine-needle aspiration cytology in diagnosing different size neck lymph nodes

Objective To investigate the value of ultrasound-guided fine-needle aspiration cytology (US-FNAC) in qualitative diagnosis of cervical lymph nodes with different sizes. Methods Data of 130 patients with 142 lymph nodes in neck treated with US-FNAC were retrospectively analyzed. The results of US-FNAC were compared with the final diagnosis confirmed by pathology and clinical follow-up. According to the short diameter, 142 lymph nodes were divided into group A (<5 mm), B (5-10 mm) and C (>10 mm) for statistical analysis. Results Sixty-five lymph nodes were diagnosed as positive metastasis by US-FNAC, including 58 malignant and 7 suspected malignant lymph nodes. The other 77 lymph nodes were diagnosed as negative metastasis by US-FNAC, including 59 benign and 18 unsatisfactory or undetermined lymph nodes. Actually, there were 70 malignant and 72 benign lymph nodes confirmed by pathology and clinical follow-up. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of US-FNAC in diagnosing malignant lymph nodes in neck was 82.35% (14/17), 95.00% (19/20), 89.19% (33/37), 93.33% (14/15) and 86.36% (19/22) in group A, 91.17% (31/34), 97.56% (40/41), 94.67% (71/75), 96.88% (31/32) and 93.02% (40/43) in group B, 94.73% (18/19), 100% (11/11), 96.67% (29/30), 100% (18/18) and 91.67% (11/12) in group C. There was no statistical difference of the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of US-FNAC among the three groups (all P>0.05). Conclusion US-FNAC is an effective method for differential diagnosis of benign and malignant lymph nodes in neck, therefore having high diagnostic efficacy to lymph nodes with different sizes.