放疗后细针穿刺细胞学检查诊断颈淋巴结转移的准确性：系统评价和荟萃分析。
Accuracy of fine-needle aspiration cytology in detecting cervical node metastasis after radiotherapy: Systematic review and meta-analysis.
机构信息
Otorhinolaryngology Unit, Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
出版信息
Head Neck. 2021 Mar;43(3):987-996. doi: 10.1002/hed.26536. Epub 2020 Nov 9.
PURPOSE
To define the accuracy of fine-needle aspiration cytology (FNAC) in diagnosing persistent or recurrent neck metastases in previously irradiated patients.
METHODS
The study was performed according to the PRISMA-DTA guidelines.
RESULTS
A total of 382 FNACs were used for calculation of diagnostic accuracy parameters. The overall pooled sensitivity and specificity in detecting malignant nodes were 69.1% (95% CI: 56.3%-80.7%; I = 79.5%) and 84.2% (95% CI: 71.8%-93.5%; I = 87.0%), respectively. Cumulative diagnostic odds ratio (DOR) was 16.54 (95% CI: 4.89-38.99; I = 65.8%), while cumulative positive and negative likelihood ratio (PLR and NLR) were 5.4 (95% CI: 2.3-11.2) and 0.37 (95% CI: 0.22-0.54), respectively.
CONCLUSIONS
FNAC alone could not guide the decision to perform a salvage neck dissection in previously irradiated patients, but its results should be assessed in relation to the specific clinical context.
目的
定义细针穿刺细胞学（FNAC）在诊断既往放疗后患者持续性或复发性颈部转移中的准确性。
方法
本研究根据 PRISMA-DTA 指南进行。
结果
共使用 382 例 FNAC 来计算诊断准确性参数。检测恶性淋巴结的总体汇总敏感性和特异性分别为 69.1%（95%CI：56.3%-80.7%；I = 79.5%）和 84.2%（95%CI：71.8%-93.5%；I = 87.0%）。累积诊断优势比（DOR）为 16.54（95%CI：4.89-38.99；I = 65.8%），而累积阳性和阴性似然比（PLR 和 NLR）分别为 5.4（95%CI：2.3-11.2）和 0.37（95%CI：0.22-0.54）。
结论
FNAC 本身不能指导对既往放疗后患者进行挽救性颈部清扫的决策，但应根据具体的临床情况评估其结果。
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