Shen Haolin, Lv Guorong, Ke Linfang, Li Ling, Zheng Chunnuan, Yang Shuping
Department of Ultrasound, Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou.
Department of Clinical Medicine, Quanzhou Medical College, Quanzhou.
Ultrasound Q. 2019 Sep;35(3):269-274. doi: 10.1097/RUQ.0000000000000427.
To distinguish malignant cervical lymphadenopathy, we established a new scoring system based on ultrasound features. Two hundred sixty-three patients with cervical lymphadenopathy received ultrasonic examination and underwent ultrasound-guided core needle biopsy or fine needle aspiration. The scoring system was proposed by multivariate logistic regression analysis and compared with Liao scoring system (0.06 × age + 4.76 × shortest-to-longest axis ratio + 2.15 × internal echo + 1.80 × vascular pattern). A new scoring system model, 1.346 × margin + 1.339 × hilum + 2.411 × calcification + 2.619 × vascular pattern + 0.837 × shortest-to-longest axis ratio, was generated. Lymph nodes were regarded as malignancy when the score was ≥2.4. Compared with the Liao scoring system, the new scoring system had larger area under the curve (0.86 versus 0.76, P = 0.036), specificity (86.7% versus 75.0%, P = 0.001), accuracy (87.1% versus 80.6%, P = 0.007), and positive predictive value (89.0% versus 80.0%, P = 0.043). Sensitivity (87.4% versus 85.3%, P = 0.647) and negative predictive value (85.0% versus 81.0%, P = 0.395) did not differ. We concluded that the new scoring system is more reliable and can play an important role in the differential diagnosis of cervical lymph nodes.
为鉴别恶性颈部淋巴结病，我们基于超声特征建立了一种新的评分系统。263例颈部淋巴结病患者接受了超声检查，并进行了超声引导下的粗针穿刺活检或细针抽吸。该评分系统通过多因素逻辑回归分析提出，并与廖氏评分系统（0.06×年龄 + 4.76×短径与长径之比 + 2.15×内部回声 + 1.80×血管形态）进行比较。生成了一个新的评分系统模型，即1.346×边界 + 1.339×门部 + 2.411×钙化 + 2.619×血管形态 + 0.837×短径与长径之比。当评分≥2.4时，淋巴结被视为恶性。与廖氏评分系统相比，新评分系统的曲线下面积更大（0.86对0.76，P = 0.036）、特异性更高（86.7%对75.0%，P = 0.001）、准确性更高（87.1%对80.6%，P = 0.007）以及阳性预测值更高（89.0%对80.0%，P = 0.043）。敏感性（87.4%对85.3%，P = 0.647）和阴性预测值（85.0%对81.0%，P = 0.395）无差异。我们得出结论，新评分系统更可靠，可在颈部淋巴结的鉴别诊断中发挥重要作用。
