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锁骨上窝淋巴结病患者的临床特征及生存分析

Clinical Characteristics and Survival Analysis of Patients with Supraclavicular Fossa Lymphadenopathy.

作者信息

Kao Yi-Jou, Hsu Wan-Lun, Chen Yong-Chen, Lo Wu-Chia, Cheng Ping-Chia, Liao Li-Jen

机构信息

School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan.

Master Program of Big Data in Medical Healthcare Industry, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan.

出版信息

Diagnostics (Basel). 2025 Jun 11;15(12):1480. doi: 10.3390/diagnostics15121480.

Abstract

Supraclavicular lymph nodes (SCLNs) are often indicative of malignancy, but the effectiveness of ultrasound (US) and hematological parameters in their assessment and the prognosis of patients with malignant SCLNs need further study. : We retrospectively reviewed 348 patients with SCLNs from July 2007 to June 2023, including patients over 18 years of age who underwent fine needle aspiration (FNA) or core needle biopsy (CNB). Our analysis focused on clinical characteristics, US features and hematological parameters to differentiate between benign and malignant SCLNs and to assess their prognostic value, especially in the Asian population. : The malignancy rate was 49%, with lung cancer (22%) and lymphoma (16%) being the most common. The malignant nodes were larger and had a greater short-to-long axis ratio, irregular margins, and abnormal vascular patterns ( < 0.01). The 5-year survival rate for patients with malignant SCLNs was 40%. Blood markers, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) (SII ≥ 970), were significant prognostic factors for overall survival (OS). Compared with lymphoma patients, patients with malignancies of supraclavicular and infraclavicular origins had significantly worse OS. : Our findings highlight the importance of ultrasound in evaluating SCLNs. Furthermore, hematological markers (NLR, PLR, and SII) and the origin of SCLNs have important prognostic value.

摘要

锁骨上淋巴结(SCLNs)常提示恶性病变,但超声(US)及血液学参数在评估锁骨上恶性淋巴结及患者预后方面的有效性仍需进一步研究。我们回顾性分析了2007年7月至2023年6月期间348例锁骨上淋巴结患者,包括18岁以上接受细针穿刺抽吸活检(FNA)或粗针穿刺活检(CNB)的患者。我们的分析聚焦于临床特征、超声特征及血液学参数,以鉴别良性与恶性锁骨上淋巴结,并评估其预后价值,尤其是在亚洲人群中。恶性率为49%,其中肺癌(22%)和淋巴瘤(16%)最为常见。恶性淋巴结更大,短径与长径比值更高,边缘不规则,且血管模式异常(<0.01)。恶性锁骨上淋巴结患者的5年生存率为40%。血液标志物,如中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及全身免疫炎症指数(SII)(SII≥970)是总生存(OS)的重要预后因素。与淋巴瘤患者相比,锁骨上及锁骨下起源恶性肿瘤患者的总生存明显更差。我们的研究结果凸显了超声在评估锁骨上淋巴结中的重要性。此外,血液学标志物(NLR、PLR和SII)及锁骨上淋巴结的起源具有重要的预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce54/12191590/cba46493804e/diagnostics-15-01480-g001.jpg

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