超声引导下浅表淋巴结细针穿刺活检的临床应用

Application of ultrasound guided fine needle biopsy for superficial lymph node

目的探讨超声引导下细针穿刺活检术在诊断浅表增大淋巴结性质中的应用价值。方法 收集2012年4月一20 13年11月接受超声引导下浅表淋巴结细针穿刺活检术患者154例临床资料,统计淋巴结大小、部位以及病因对病理诊断结果的影响。结果 154例均取材成功,取材成功率为100%。淋巴结特征与明确诊断的关系：淋巴结部位,颈部51例,明确诊断48例（94.1%）;锁骨上区63例,明确诊断6 1例（96.8%）;腋窝17例,明确诊断14例（82.3%）;腹股沟区23例,明确诊断19例（82.6%）。淋巴结直径：〈0.5 cm 2例,无1例明确诊断;0.5～1.0 cm14例,明确诊断9例（64.3%）;〉1.0 cm者138例,明确诊断者128例（92.7%）。淋巴结形态：形态异常者124例,明确诊断115例（92.7%）。与周围组织器官的关系：与周围组织有粘连者95例,明确诊断84例（88.4%）病理诊断结果 ：恶性病变81例（52.6%）,其中肿瘤淋巴结转移55例（35.7%）,恶性淋巴瘤26例（16.9%）;炎性反应性增生淋巴结34例（22.1%）;淋巴结结核22例（14.3%）;假阴性5例（3.2%）;性质不确定12例（7.8%）。结论 超声引导下细针穿刺活检术对浅表增大淋巴结诊断具有实时观察、安全、准确、创伤小等优点,标本满意率及病理诊断准确率高,是浅表增大淋巴结定性诊断的首选方法 。

Objective To evaluate the clinical value of ultrasound guided fine needle biopsy in the diagnosis of superficial lymphadenectasis.Methods From April 2012 to November 2013,154 subjects were collected.All of them were treated with ultrasound guided fine needle biopsy of superficial lymph node.Their size,location,pathological types of the superficial lymphadenectasis were analyzed and their influence on pathological diagnosis were also studied.Results 154 cases were drawn success sample,with a success rate of 100%.Relationship characteristics and diagnosis of lymph nodes：lymph site,neck in 51 cases,diagnosed in 48 cases（94.1%）;63 cases in supraclavicular region,a definite diagnosis in 61 cases（96.8%）;armpit in 17 cases,diagnosed in 14 cases（82.3%）,groin area of 23 cases,diagnosed in 19 patients（82.6%）.Lymph node diameter;〈0.5 cm in 2 cases without definite diagnosis,0.5-1.0 cm in 14 cases with definite diagnose in 9 cases（64.3%）, 〉1.0 cm were 138 cases and diagnosed in 128 cases（92.7%）.Lymph node morphology：morphological abnormalities were found in 124 cases and diagnosed in 115 cases（92.7%）.Relationship with the surrounding tissues and organs;the surrounding tissue adhesions in 95 cases,diagnosed in 84 cases（88.4%）.Pathological diagnosis;malignant lesions in 81 cases（52.6%）,including 55 cases of lymph node metastasis（35.7%）,malignant lymphoma of 26cases（16.9%）;inflammatory reactive hyperplasia of lymph nodes in 34 cases（22.1%）;lymph node tuberculosis in 22 patients（14.3%）;false negative in 5 cases（3.2%）;nature uncertain in 12 cases（7.8%）.Conclusion Ultrasound guided fine needle biopsy for superficial lymph node is real time imaging.It is a minimally invasive technique.It is also safe and accurate.The rate of satisfactory specimens and pathological diagnosis were high.It is one of the best techniques in the diagnosis of superficial lymphadenectasis.