超声引导穿刺活检在舌鳞癌术前颈部淋巴结转移诊断中的临床应用

目的探索一种确定术式和评估预后的方法,以提高舌鳞癌颈部淋巴结转移诊断准确率。方法利用自动弹射活检装置在超声引导下对37例舌鳞癌颈部淋巴结穿刺活检。以颈淋巴结清扫术或颈淋巴结探查术后对淋巴结检查的病理结果为标准,比较超声引导穿刺活检与临床触诊对淋巴结转移的诊断准确性。结果超声引导穿刺活检诊断符合率为94.59%,较临床触诊的59.46%高,假阴性率低,无假阳性,两种方法对诊断淋巴结转移的准确指数差异有统计学意义。结论超声引导穿刺活检可以提高舌鳞癌淋巴结转移诊断准确率,舌鳞癌术前可常规用超声检查颈部淋巴结,对可疑转移的淋巴结进行穿刺活检以确定病变性质。

Clinical application of ultrasound guided aspiration biopsy in the diagnosis of cervical lymph node metastasis before the surgery of squamous cell carcinoma of the tongue

Objective To improve the diagnosis accuracy of the lymphatic metastasis of squamous cell carcinoma of the tongue, and explore a method to determine surgery procedure and estimate prognoses. Methods Automatic ejection biopsy device was used to perform aspiration biopsy on the cervical lymph nodes of squamous cell carcinoma of the tongue in 37 cases under ultrasound guidance. Using the pathological examination results on the lymph glands obtained from neck dissection or the incision and exploration of cervical lymph nodes as standard, the diagnosis accuracy for lymphatic metastasis of ultrasound guided aspiration biopsy was compared to that of clinical palpation. Results The diagnostic accordance rate of ultrasound guided aspiration biopsy was 94.59%, which was higher than that of clinical palpation (59.46%). The false negative rate was low, and there was no false positive case. There was significant difference in the accuracy index of lymphatic metastasis diagnosis between the two methods. Conclusions Ultrasound guided aspiration biopsy can improve the diagnosis accuracy of the lymphatic metastasis of squamous cell carcinoma of the tongue.Therefore , cervical lymph node ultrasonic examination and the aspiration biopsy of the lymph nodes with suspicious metastasis can be routinely conducted before the surgery of squamous cell carcinoma of the tongue in order to determine the properties of the pathological changes.