Department of Ultrasound, National Cancer Center/National Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Chin Clin Oncol. 2020 Apr;9(2):12. doi: 10.21037/cco.2019.08.18. Epub 2019 Sep 9.
To analyze the diagnostic value of ultrasound-guided fine-needle aspiration (FNA) biopsy for lymph nodes with short-axis diameters ≤1 cm and to investigate whether the short-axis diameter influences the results of FNA biopsy.
The cytological results of ultrasound-guided FNA lymph node biopsies in 1,242 cases treated at our hospital between December 2015 and June 2017 were retrospectively analyzed. The results were compared with the final diagnostic results of the cases (988 cases had core-needle biopsies, and 254 cases were followed-up for more than six months) to explore the diagnostic value of ultrasound-guided FNA for small lymph nodes.
The sensitivities, specificities and accuracies of ultrasound-guided FNA were 99.6%, 99.5% and 99.5% for small lymph nodes with short-axis diameters ≤1 cm and 97.2%, 94.4% and 96.4% for lymph nodes with short-axis diameters >1 cm, respectively. No significant differences were detected between the two groups (P>0.05). Lymph nodes with short-axis diameters ≤1 cm were divided into three groups according to the following diameters: 0.7 cm ≤ short-axis diameter ≤1 cm, 0.5 cm ≤ short-axis diameter <0.7 cm, and short-axis diameter <0.5 cm. The sensitivities of ultrasound-guided FNA for these three groups were 99.6%, 99.5% and 98.0% respectively; the specificities were 99.5%, 99.0% and 98.0%, respectively; and the accuracies were 99.8%, 99.3% and 99.0%, respectively. The differences in accuracy between the three groups were significant (P<0.05), while the differences in sensitivity and specificity were not significant (P>0.05).
The diagnostic results of ultrasound-guided FNA for small lymph nodes are not affected by the short-axis diameter. For lymph nodes with short-axis diameters ≤1 cm, the accuracy decreases as the short-axis diameter decreases, but FNA still has a high diagnostic accuracy for these small lymph nodes.
分析超声引导下细针抽吸(FNA)活检对短轴直径≤1cm 的淋巴结的诊断价值,并探讨短轴直径是否影响 FNA 活检的结果。
回顾性分析我院 2015 年 12 月至 2017 年 6 月期间接受超声引导下 FNA 淋巴结活检的 1242 例患者的细胞学结果。将结果与病例的最终诊断结果(988 例有芯针活检,254 例随访时间超过 6 个月)进行比较,以探讨超声引导下 FNA 对小淋巴结的诊断价值。
超声引导下 FNA 对短轴直径≤1cm 的小淋巴结的灵敏度、特异度和准确率分别为 99.6%、99.5%和 99.5%,对短轴直径>1cm 的淋巴结分别为 97.2%、94.4%和 96.4%,两组间差异无统计学意义(P>0.05)。将短轴直径≤1cm 的淋巴结根据以下直径分为三组:0.7cm≤短轴直径≤1cm、0.5cm≤短轴直径<0.7cm 和短轴直径<0.5cm。超声引导下 FNA 对这三组的灵敏度分别为 99.6%、99.5%和 98.0%;特异度分别为 99.5%、99.0%和 98.0%;准确率分别为 99.8%、99.3%和 99.0%。三组间准确率差异有统计学意义(P<0.05),而灵敏度和特异度差异无统计学意义(P>0.05)。
超声引导下 FNA 对小淋巴结的诊断结果不受短轴直径的影响。对于短轴直径≤1cm 的淋巴结,随着短轴直径的减小,准确性降低,但 FNA 对这些小淋巴结仍具有较高的诊断准确性。