Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri, USA.
Department of Pathology and Laboratory Medicine, University of Utah & ARUP Laboratories, Salt Lake City, Utah, USA.
Diagn Cytopathol. 2021 Feb;49(2):181-186. doi: 10.1002/dc.24617. Epub 2020 Sep 17.
Fine-needle aspiration (FNA) is commonly used to investigate lymphadenopathy of suspected metastatic origin. While diagnostic accuracy of FNA for lymph node disease is well described, the relationship between node size, percent tumor replacement, and size of metastatic deposit with diagnostic accuracy is less well documented.
All axillary lymph nodes undergoing ultrasound-guided FNA for suspected breast metastases were correlated with subsequent surgical excision specimens. FNAs were judged as positive or negative for malignancy and the percent of false negative FNAs was correlated with node size, percent tumor replacement and size of metastatic deposit RESULTS: Sensitivities were calculated for nodes greater than 15 mm (92%), nodes 11 to 14.9 mm (83%), nodes 7 to 10.9 mm (61%), and for nodes less than 7 mm (60%). Sensitivity increases with increasing node size (P = .001). Percent tumor replacement correlated with sensitivity: 90% or greater replacement (85%) 60% to 89.9% replacement (75%), 40% to 59.9% replacement (75%) and less than 39.9% replacement (64%)(P < .001). Metastases size correlated with sensitivity: metastases greater than 10 mm (94%), 6 to 9.9 mm (70%), 4 to 5.9 mm (54%), and less than 4 mm (72%).
Percentage of false negative FNAs associate with investigation of metastatic disease correlates with node size, size of metastatic deposit and percentage of nodes replaced by tumor. Lymph nodes smaller than 7 mm, deposit diameter less than 6 mm and percentage replacement of less than 40% have the highest percentage of false negative results.
细针抽吸(FNA)常用于研究疑似转移性起源的淋巴结病。虽然 FNA 对淋巴结疾病的诊断准确性已有很好的描述,但淋巴结大小、肿瘤替代百分比和转移性沉积物大小与诊断准确性之间的关系记录较少。
所有因疑似乳腺癌转移而行超声引导 FNA 的腋窝淋巴结均与随后的手术切除标本相关。FNA 被判断为恶性或良性,并将假阴性 FNA 的百分比与淋巴结大小、肿瘤替代百分比和转移性沉积物大小相关。
计算了大于 15mm(92%)、11 至 14.9mm(83%)、7 至 10.9mm(61%)和小于 7mm(60%)的淋巴结的敏感性。敏感性随淋巴结增大而增加(P=0.001)。肿瘤替代百分比与敏感性相关:90%或更高替代(85%)、60%至 89.9%替代(75%)、40%至 59.9%替代(75%)和小于 39.9%替代(64%)(P<0.001)。转移灶大小与敏感性相关:大于 10mm(94%)、6 至 9.9mm(70%)、4 至 5.9mm(54%)和小于 4mm(72%)。
假阴性 FNA 的百分比与转移性疾病的研究相关,与淋巴结大小、转移性沉积物大小和肿瘤替代百分比相关。小于 7mm 的淋巴结、小于 6mm 的沉积直径和小于 40%的替代百分比具有最高的假阴性结果百分比。