Dept of Pathology, University of Utah School of Medicine, 15 N Medical Dr E, Salt Lake City, UT 84112;
Am J Clin Pathol. 2013 Nov;140(5):635-42. doi: 10.1309/AJCPWSDDHLLW40WI.
To perform a thorough review and meta-analysis of studies that have shown non-image-guided fine-needle aspiration cytology (FNAC) to be highly sensitive and specific for assessing questionable metastatic melanoma to lymph nodes.
MEDLINE and Scopus were searched for potentially relevant articles with a search string including the words "melanoma" and "fine needle." All relevant articles were screened by two authors (B.J.H. and R.L.S.). Full articles were screened for extractable data, and the data was pooled for analysis.
Of 978 unique studies found, 10 (5,518 cases) met our inclusion criteria. In a pooled analysis of palpation and ultrasound-guided fine-needle aspirations, the area under the receiver operating characteristic curve was 0.99 (95% confidence interval [CI], 0.99-1.00). The summary estimates for the sensitivity and specificity were 0.97 (95% CI, 0.95-0.98) and 0.98 (95% CI, 0.98-1.00), respectively.
With a sensitivity and specificity of 0.97 and 0.99, the overall diagnostic accuracy of FNAC for metastatic melanoma is quite high, and with a positive and negative likelihood ratio of 58 and 0.03, FNAC for metastatic melanoma should be the first-line option in a patient with a clinically suspected mass and a history of melanoma.
对已发表的研究进行全面回顾和荟萃分析，这些研究表明，非影像引导下的细针抽吸细胞学（FNAC）在评估可疑转移性黑色素瘤至淋巴结方面具有高度的敏感性和特异性。
使用 MEDLINE 和 Scopus 搜索可能相关的文章，搜索词包括“黑色素瘤”和“细针”。两位作者（BJH 和 RLS）筛选所有相关文章。筛选出可提取数据的全文，并对数据进行汇总分析。
在 978 篇独特的研究中，有 10 篇（5518 例）符合我们的纳入标准。在对触诊和超声引导下的细针抽吸的汇总分析中，接受者操作特征曲线下的面积为 0.99（95%置信区间[CI]，0.99-1.00）。汇总估计的敏感性和特异性分别为 0.97（95%CI，0.95-0.98）和 0.98（95%CI，0.98-1.00）。
FNAC 对转移性黑色素瘤的总体诊断准确性相当高，其敏感性和特异性分别为 0.97 和 0.99，阳性和阴性似然比分别为 58 和 0.03。对于有临床可疑肿块和黑色素瘤病史的患者，FNAC 应作为一线选择。
