Abedini Atefeh, Razavi Fatemeh, Mehravaran Hossein, Toutkaboni Mihan Pourabdollah, Kashefizadeh Alireza, Emami Habib, Kazempour-Dizaji Mehdi, Farahani Mehrdad, Kiani Arda
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Oman Med J. 2020 Apr 30;35(2):e112. doi: 10.5001/omj.2020.30. eCollection 2020 Mar.
In countries with a high prevalence of tuberculosis, such as Iran, the differentiation of malignant from non-malignant tumors is crucial. We attempted to find a reliable model in determining malignant nodes by investigating the sonographic characteristics of lymph nodes (LNs).
In this prospective study, the morphologic characteristics of LNs, including size, shape, vascular pattern, echogenicity, margin, coagulation necrosis sign, calcification, and central hilar structure, which had been obtained during endobronchial ultrasound-guided transbronchial needle aspiration, were compared with the final pathology results.
We examined 253 LNs from 93 patients. Round shape, non-hilar vascular pattern, heterogeneous echogenicity, hyperechogenicity, distinct margin, and the existence of necrosis signs were significantly higher in malignant nodes. On the other hand, the existence of calcification, as well as the presence of central hilar structure, were highly suggestive of benign nodes ( < 0.050). Multivariate logistic regression revealed that size > 1 cm, heterogeneous echogenicity, hyperechogenicity, the existence of necrosis signs, and the lack of central hilar structure are independent predictive factors for malignancy. The accuracy of each of the aforementioned characteristics are 42.3%, 71.5%, 71.9%, 73.5%, and 65.6%, respectively. Of 74 malignant LNs, 100% had at least one of these independent factors.
The morphological features of LNs based on endobronchial ultrasound-guided transbronchial needle aspiration can play a role in predicting malignancy.
在结核病高发国家，如伊朗，区分恶性肿瘤与非恶性肿瘤至关重要。我们试图通过研究淋巴结（LN）的超声特征来找到一种确定恶性淋巴结的可靠模型。
在这项前瞻性研究中，将经支气管超声引导下经支气管针吸活检获取的LN的形态学特征，包括大小、形状、血管模式、回声性、边缘、凝固性坏死征象、钙化和中央肺门结构，与最终病理结果进行比较。
我们检查了93例患者的253个LN。恶性淋巴结中圆形、非肺门血管模式、不均匀回声性、高回声性、清晰边缘及坏死征象的存在明显更多。另一方面，钙化的存在以及中央肺门结构的存在强烈提示为良性淋巴结（P<0.050）。多因素逻辑回归显示，大小>1 cm、不均匀回声性、高回声性、坏死征象的存在以及缺乏中央肺门结构是恶性肿瘤的独立预测因素。上述各特征的准确率分别为42.3%、71.5%、71.9%、73.5%和65.6%。在74个恶性LN中，100%至少具有这些独立因素中的一项。
基于经支气管超声引导下经支气管针吸活检的LN形态学特征可在预测恶性肿瘤方面发挥作用。
