Department of Ultrasound Diagnosis, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, Hunan, China.
Department of Otolaryngology Head and Neck Surgery, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, Hunan, China.
Medicine (Baltimore). 2024 Jul 5;103(27):e38391. doi: 10.1097/MD.0000000000038391.
The objective was to assess the diagnostic efficacy of Doppler ultrasound in detecting cervical lymph nodes in patients diagnosed with laryngeal and hypopharyngeal cancers. Patients undergoing surgery for laryngeal and hypopharyngeal cancers in the Otolaryngology Department from January 2021 to January 2023 were included. Two groups, with equal numbers, underwent ultrasound examination and intensive CT examination in the experimental and control groups, respectively, along with routine cervical lymph node dissection. A resident with over 6 years of clinical experience in the otolaryngology department performed routine bilateral cervical lymph node palpation. Sensitivity, specificity, and validity were compared among different examination methods. The McNemar test assessed specificity and sensitivity between palpation, color Doppler ultrasonography, and enhanced CT, while the Kappa concordance test evaluated the concordance between the 2 examination methods. Data were statistically analyzed using SPSS 23.0. Palpation showed a diagnostic sensitivity (DS) of 52.83% and specificity of 91.11% for all patients with cervical lymph node metastasis. Ultrasonography demonstrated a DS of 77.78% and specificity of 81.82% in patients with cervical lymph node metastasis, while intensive CT had a DS of 75.86% and specificity of 60.00%. Statistical significance (P < .05) was observed in the sensitivity between palpation and ultrasonography, and between palpation and enhanced CT. The specificity between enhanced CT and ultrasonography (P = .021) and between palpation and enhanced CT scan (P = .003) both showed statistical significance (P < .05). Doppler ultrasound yields diagnostic results highly consistent with pathological diagnoses in patients with laryngeal and hypopharyngeal cancers. Utilizing Doppler ultrasound can enhance the accuracy of diagnosing these cancers, aiding physicians in devising more suitable treatment plans for patients.
评估多普勒超声在诊断喉和下咽癌患者颈淋巴结中的诊断效能。
选择 2021 年 1 月至 2023 年 1 月在耳鼻喉科行手术治疗的喉和下咽癌患者。实验组和对照组分别进行超声检查和强化 CT 检查，常规进行颈淋巴结清扫术。由一名具有 6 年以上耳鼻喉科临床经验的住院医师进行常规双侧颈淋巴结触诊。比较不同检查方法的敏感性、特异性和准确性。采用 McNemar 检验评估触诊、彩色多普勒超声和增强 CT 之间的特异性和敏感性，采用 Kappa 一致性检验评估两种检查方法的一致性。采用 SPSS 23.0 进行数据统计分析。
所有颈淋巴结转移患者触诊的诊断敏感性（DS）为 52.83%，特异性为 91.11%。超声检查显示颈淋巴结转移患者的 DS 为 77.78%，特异性为 81.82%，强化 CT 的 DS 为 75.86%，特异性为 60.00%。触诊与超声、触诊与强化 CT 之间的敏感性差异有统计学意义（P < .05）。增强 CT 与超声（P = .021）和触诊与增强 CT 之间的特异性（P = .003）差异均有统计学意义（P < .05）。
多普勒超声检查在喉和下咽癌患者中与病理诊断结果高度一致。利用多普勒超声可以提高这些癌症的诊断准确性，有助于医生为患者制定更合适的治疗计划。
