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超声引导下细针穿刺抽吸术与细针毛细管采样术在评估甲状腺癌淋巴结转移中的比较

Ultrasound-Guided Fine-Needle Aspiration Versus Fine-Needle Capillary Sampling in Evaluation of Lymph Node Metastasis of Thyroid Cancer.

作者信息

Xia Shujun, Chen Yilai, Zhan Weiwei, Zhou Wei

机构信息

Department of Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Ultrasound, Ruijin Hospital/Lu Wan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

出版信息

Front Oncol. 2021 Apr 14;11:642142. doi: 10.3389/fonc.2021.642142. eCollection 2021.

Abstract

BACKGROUND

To compare the sampling adequacy and diagnostic efficiency of ultrasound-guided fine-needle aspiration with 22-, 25-gauge needles and capillary sampling with 22-gauge needle in the biopsy of cervical lymph node.

METHODS

A total of 130 cervical lymph nodes from 103 patients were consecutively included in the prospective study. Each suspected lymph node was aspirated with a 22-gauge needle, capillary sampled with a 22-gauge needle and aspirated with a 25-gauge needle. The adequacy rates and nondiagnostic rates of obtained specimen were calculated.

RESULTS

Of the 130 suspected lymph nodes, there were 77 lymph nodes<6.0 mm and 53 lymph nodes≥6.0mm in the smallest dimension. Both FNA and FNC got significantly higher sampling adequacy than FNA for the total lymph nodes. For lymph nodes<6.0 mm, the sampling adequacy was significantly higher with FNA than with FNA for each parameter and the cumulative score (all P<0.05), while no difference were seen between FNA and FNC, and between FNC and FNA. There were higher nondiagnostic rates for FNA compared with FNA and FNC in all lymph nodes and in each size subgroups. FNA yielded more diagnostically inadequate specimens than FNA and FNC did in the total lymph nodes (P=0.002), in lymph nodes<6.0 mm (P=0.014), and in those ≥ 6.0 mm (P=0.000).

CONCLUSIONS

FNA and FNC obtained more diagnostically adequate specimens than FNA in cervical lymph nodes. FNA and FNC may be more suitable than FNA in diagnosing cervical lymph nodes. FNA and FNC may yield specimens with similar quality.

摘要

背景

比较超声引导下使用22号、25号针进行细针穿刺抽吸以及使用22号针进行毛细采样在颈部淋巴结活检中的采样充分性和诊断效率。

方法

103例患者的130个颈部淋巴结连续纳入前瞻性研究。每个可疑淋巴结先用22号针抽吸,再用22号针进行毛细采样,最后用25号针抽吸。计算所获标本的充分率和非诊断率。

结果

130个可疑淋巴结中,最小径<6.0 mm的淋巴结有77个,≥6.0 mm的淋巴结有53个。对于所有淋巴结,FNA(细针穿刺抽吸)和FNC(毛细采样)的采样充分性均显著高于FNA。对于<6.0 mm的淋巴结,FNA在各项参数及累积评分上的采样充分性均显著高于FNA(均P<0.05),而FNA与FNC之间、FNC与FNA之间无差异。在所有淋巴结及各大小亚组中,FNA的非诊断率均高于FNA和FNC。在所有淋巴结、<6.0 mm的淋巴结以及≥6.0 mm的淋巴结中,FNA产生的诊断不充分标本均多于FNA和FNC(P=0.002、P=0.014、P=0.000)。

结论

在颈部淋巴结活检中,FNA和FNC获得的诊断充分标本多于FNA。在诊断颈部淋巴结方面,FNA和FNC可能比FNA更合适。FNA和FNC可能产生质量相似的标本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c027/8079778/a8c7ded60f2f/fonc-11-642142-g001.jpg

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