摘要
目的:探讨超声下粗针穿刺(US-CNB)、超声下细针穿刺(US-FNAB)联合检查对于诊断锁骨上肿大淋巴结良恶性的临床价值。方法:选取2021年1月~2023年12月经本院诊断为锁骨上淋巴结肿大患者70例,根据病理学性质进行分为恶性肿瘤淋巴结转移47例(恶性组)和良性淋巴结肿大23例(良性组)。统计47例恶性肿瘤转移淋巴结患者的原发疾病情况,比较恶性组和良性组的淋巴结超声特征,包括横径、纵横径之比、淋巴结形态、回声、淋巴门、钙化灶等,并比较US-CNB、US-FNAB单独及联合应用诊断效能。结果:47例恶性肿瘤出现锁骨上淋巴结转移的患者,其中肺癌13例(27.66%)、食管癌11例(23.40%)、甲状腺癌12例(25.53%);恶性组和良性组患者的淋巴结横径、纵横径之比差异无统计学意义(P>0.05);恶性组淋巴结形态不规则、回声不均匀率、未检出淋巴门、淋巴结中钙化灶检出率高于良性组,差异具有统计学意义(P<0.05)。US-CNB诊断锁骨上良恶性淋巴结的灵敏度为87.23%,特异度为95.65%;US-FNAB诊断锁骨上良恶性淋巴结的灵敏度为80.85%,特异度为91.30%;联合诊断锁骨上良恶性淋巴结的灵敏度为97.87%,特异度为86.96%。结论:US-CNB、US-FNAB单独应用鉴别诊断锁骨上良恶性淋巴结均具有较高的价值,但是二者联合对于提高诊断的灵敏度有重要意义。
Objective:To investigate the clinical value of combined ultrasonic thick needle puncture(US-CNB)and ultrasonic fine needle puncture(US-FNAB)in the diagnosis of benign and malignant supraclavicular enlarged lymph nodes.Methods:A total of 70 patients diagnosed with supraclavicular lymph node enlargement in our hospital from January 2021 to December 2023 were selected and divided into 47 cases of malignant tumor lymph node metastasis(malignant group)and 23 cases of benign lymph node enlargement(benign group)according to the pathological nature.The primary disease conditions of 47 patients with metastatic lymph nodes of malignant tumors were statistically analyzed.The ultrasound characteristics of lymph nodes in the malignant group and the benign group were compared,including transverse diameter,ratio of longitudinal to transverse diameter,lymph node morphology,echo,lymphatic phylum,calcification foci,etc.The diagnostic efficacy of US-CNB and US-FNAB alone and in combination was also compared.Results:Among the 47 patients with supraclavicular lymph node metastasis of malignant tumors,13 cases(27.66%)were lung cancer,11 cases(23.40%)were esophageal cancer,and 12 cases(25.53%)were thyroid cancer.There was no statistically significant difference in the ratio of transverse and longitudinal diameters of lymph nodes between the malignant group and the benign group(P>0.05).The rates of irregular lymph node morphology,uneven echo,undetected lymph nodes,and calcified foci in lymph nodes in the malignant group were higher than those in the benign group,and the differences were statistically significant(P<0.05).The sensitivity of US-CNB in diagnosing benign and malignant supraclavicular lymph nodes was 87.23%,and the specificity was 95.65%.The sensitivity of US-FNAB in diagnosing benign and malignant supraclavicular lymph nodes was 80.85%,and the specificity was 91.30%.The sensitivity of the combined diagnosis of benign and malignant supraclavicular lymph nodes was 97.87%,and the specificity was 86.96%.Conclusion:US-CNB and US-FNAB alone have high value in differential diagnosis of supraclavicular benign and malignant lymph nodes,but their combination is of great significance in improving the diagnostic sensitivity.
作者
罗志梅
曹太阳
LUO Zhi-mei;CAO Tai-yang(Department of Pathology,Xinfeng County People’s Hospital of Jiangxi Province,Jiangxi Ganzhou 341600;Department of Spine Surgery,Xinfeng County People’s Hospital of Jiangxi Province,Jiangxi Ganzhou 341600)
出处
《中国医疗器械信息》
2025年第21期112-115,共4页
China Medical Device Information
关键词
超声引导
粗针穿刺
细针穿刺
诊断
锁骨上肿大淋巴结
ultrasound guidance
coarse needle puncture
fine needle puncture
diagnosis
supraclavicular enlarged lymph nodes
