超声引导下穿刺活检在术前诊断舌体鳞癌颈部淋巴结转移中的临床应用

Clinical application of ultrasound-guided needle biopsy for preoperative diagnosis of squamous carcinoma of tongue with cervical lymphatic metastasis

目的探索超声引导下穿刺活检在舌体鳞癌颈部淋巴结转移诊断中的临床应用。方法超声引导下利用自动弹射活检装置对37例舌体鳞癌颈部淋巴结作穿刺活检。以病理结果为标准，比较经超声引导下穿刺活检与临床触诊诊断淋巴结转移的价值。结果经超声引导下穿刺活检诊断淋巴结转移的敏感性为100％，特异性为86．7％，准确性为94．5％，阳性预测值91．7％，阳性似然比7．50；临床触诊诊断淋巴结转移的敏感性为76．5％，特异性为45．0％，准确性为59．5％，阳性预测值54．2％，阳性似然比1．39，两者差异有统计学意义。结论经超声引导穿刺活检较临床触诊诊断方法诊断淋巴结转移可靠和准确，并可提供病变性质依据，值得临床推广应用。

Objective To explore the clinical application of ultrasound - guided needle biopsy for diagnosis of squamous carcinoma of tongue with cervical lymphatic metastasis. Methods Thirty - seven cases of squamous carcinoma of tongue with cervical lymphatic metastasis were punctured by automatic ejection biopsy device under ultrasound guidance. The pathological results after operation as standard, then the value of ultrasound - guided needle biopsy and clinical palpation in diagnosis of lymphatic metastasis was compared. Results The sensibility, specificity, accuracy, positive predicted value and positive likelihood ratio of ultrasound - guided needle biopsy and clinical palpation were 100% , 86.7% , 94.5% , 91.7% ,7.50 and 76.5% , 45.0%, 59.5% , 54.2% ,1.39, respectively. There was significant difference between the two methods. Conclusion Compared with clinical palpation, ultrasoundguided needle biopsy can diagnose lymphatic metastasis accurately, it has important application value in clinic.