Warshavsky Anton, Rosen Roni, Perry Chava, Muhanna Nidal, Ungar Omer J, Carmel-Neiderman Narin Nard, Fliss Dan M, Horowitz Gilad
The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
The Institute of Hematology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Head Neck. 2020 Oct;42(10):3051-3060. doi: 10.1002/hed.26381. Epub 2020 Aug 4.
The diagnostic yield of core needle biopsies (CNB) in cervical lymphadenopathy for lymphoma diagnosis is controversial. The aim of this study was to calculate the accuracy of cervical CNB in diagnosing lymphoma.
We conducted a meta-analysis of all studies on patients presenting with cervical lymphadenopathy and referred to CNB. Patients with a diagnosis other than lymphoma were excluded. All cases diagnosed with lymphoma sufficient to guide treatment based on CNB outcome were considered accurate (actionable) results. A separate meta-analysis was performed for various lymphoma subtypes.
Three prospective and 19 retrospective studies, comprising 1120 patients, met the inclusion criteria. The rate of actionable lymphoma diagnoses following CNB ranged from 30% to 96.3%, with a random-effects model of 82.45% (95% confidence interval [CI] =0.76-0.88) and a fixed-effects model of 78.3% (95% CI =0.75-0.80).
CNB for cervical lymphadenopathy in lymphoma cases is relatively accurate in guiding treatment.
在淋巴瘤诊断中，粗针穿刺活检（CNB）对颈部淋巴结病的诊断价值存在争议。本研究旨在计算颈部CNB诊断淋巴瘤的准确性。
我们对所有关于颈部淋巴结病患者并接受CNB检查的研究进行了荟萃分析。排除淋巴瘤以外诊断的患者。所有基于CNB结果诊断为淋巴瘤且足以指导治疗的病例被视为准确（可采取行动）的结果。对各种淋巴瘤亚型进行了单独的荟萃分析。
三项前瞻性研究和19项回顾性研究，共1120例患者，符合纳入标准。CNB后可采取行动的淋巴瘤诊断率在30%至96.3%之间，随机效应模型为82.45%（95%置信区间[CI]=0.76-0.88），固定效应模型为78.3%（95%CI=0.75-0.80）。
在淋巴瘤病例中，颈部淋巴结病的CNB在指导治疗方面相对准确。
