Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.
Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy ; Sapienza Università di Roma, Dpt. Scienze Biotecnologie Medico-Chirurgiche, Rome, Italy.
Radiol Oncol. 2014 Jan 22;48(1):29-34. doi: 10.2478/raon-2013-0084. eCollection 2014 Mar.
The primary aim of this study was to evaluate the diagnostic accuracy of ultrasound (US) in the study of superficial lymph nodes during the follow-up of patients surgically treated for skin tumours. The secondary objective was to compare positive cytological results with histological reports.
From 2004 to 2011, 480 patients (male/female: 285/195; median age 57 years; prevalent skin tumour: melanoma) underwent US-guided fine-needle aspiration biopsy (FNAB) of suspicious recurrent lymph nodes. An expert radiologist first performed US testing of the lymph nodes, expressing either a negative or positive outcome of the test. Subsequently, US-guided FNAB was performed. FNAB positive patients were subjected to lymphadenectomy; the patients who tested negative underwent the follow-up.
The size of lymph nodes was ≤ 2 cm in 90% of cases. Out of the 336 (70%) US "positive" patients, 231 (68.8%) were FNAB positives. Out of the 144 (30%) US "negatives", 132 (91.7%) were FNAB negatives. The sensitivity and specificity of the US were 95% and 55.7%, respectively; the negative predictive value was 91.7% and the positive predictive value was 68.8%. Definitive histological results confirmed FNAB positivity in 97.5% of lymphadenectomies.
US is a sensitive method in the evaluation of superficial lymph nodes during the follow-up of patients with skin tumours. High positive predictive value of cytology was confirmed.
本研究的主要目的是评估超声（US）在皮肤肿瘤患者手术后随访中对浅表淋巴结的诊断准确性。次要目的是比较细胞学阳性结果与组织学报告。
2004 年至 2011 年，480 例患者（男/女：285/195；中位年龄 57 岁；常见皮肤肿瘤：黑色素瘤）接受了可疑复发性淋巴结的超声引导细针抽吸活检（FNAB）。一位专家放射科医生首先对淋巴结进行超声检测，表达检测结果为阴性或阳性。随后进行超声引导下 FNAB。FNAB 阳性患者行淋巴结切除术；FNAB 阴性患者行随访。
90%的淋巴结大小≤2cm。在 336 例（70%）US“阳性”患者中，231 例（68.8%）FNAB 阳性。在 144 例（30%）US“阴性”患者中，132 例（91.7%）FNAB 阴性。US 的灵敏度和特异性分别为 95%和 55.7%；阴性预测值为 91.7%，阳性预测值为 68.8%。确定性组织学结果证实淋巴结切除术的 FNAB 阳性率为 97.5%。
US 是评估皮肤肿瘤患者随访中浅表淋巴结的一种敏感方法。细胞学的阳性预测值较高得到了证实。
