Schoengen A, Binder T, Fembacher P, Zeelen U
Abteilung für Innere Medizin, Bundeswehrkrankenhaus, Ulm.
Dtsch Med Wochenschr. 1995 Apr 21;120(16):549-54. doi: 10.1055/s-2008-1055377.
To examine the usefulness of fine needle aspiration cytology in the investigation of patients with enlarged lymph nodes, the authors made a retrospective evaluation of the results of 1158 aspirations in 838 patients (630 male, 208 female, mean age 44 [4-90] years). In these 1158 cases the diagnosis was verified histologically, serologically or by follow up extending over at least six months. In 94.6% (n = 1096) the aspirate gave an unequivocal diagnosis, in 4.2% (n = 48) the diagnosis was equivocal and in 1.2% (n = 14) no diagnosis was reached. There were 773 correct malignant results, 368 correct benign results and 16 false benign; in one case the assessment was false malignant. Sensitivity was 98% and specificity 99.7%. In benign lymphadenopathies the investigation achieved a specificity of 99.7%, and in metastases and malignant lymphomas the sensitivity was 97.8% and 98.2% respectively. In 211 out of 286 aspirations the cytological diagnosis correctly predicted the subsequent histological diagnosis; in 58 cases correct though imprecise expressions such as "highly malignant non-Hodgkin's lymphoma" were employed. No serious complications were encountered. Fine needle aspiration cytology enables the clinician to devise an exact diagnostic and therapeutic plan in nearly every patient with unexplained lymph node enlargement.
为了检验细针穿刺细胞学检查在肿大淋巴结患者检查中的实用性，作者对838例患者（男630例，女208例，平均年龄44岁[4 - 90岁]）的1158次穿刺结果进行了回顾性评估。在这1158例病例中，诊断通过组织学、血清学或至少持续6个月的随访得以验证。94.6%（n = 1096）的穿刺给出了明确诊断，4.2%（n = 48）的诊断不明确，1.2%（n = 14）未得出诊断结果。有773例恶性结果正确，368例良性结果正确，16例假性良性；1例评估为假恶性。敏感性为98%，特异性为99.7%。在良性淋巴结病中，该检查的特异性为99.7%，在转移瘤和恶性淋巴瘤中，敏感性分别为97.8%和98.2%。在286次穿刺中的211次，细胞学诊断正确地预测了随后的组织学诊断；在58例中，使用了正确但不精确的表述，如“高度恶性非霍奇金淋巴瘤”。未遇到严重并发症。细针穿刺细胞学检查使临床医生能够为几乎每一位不明原因淋巴结肿大的患者制定精确的诊断和治疗方案。
