高频超声与CT检查对恶性锁骨上淋巴结诊断价值的对比研究

Comparative study of high frequency ultrasound and CT in diagnosis of malignant supraclavicular nodes

目的:探讨高频超声及计算机断层扫描(CT)在恶性肿瘤锁骨上淋巴结转移中的应用价值。方法:回顾分析在江苏大学附属宜兴医院就诊的144例恶性肿瘤患者,高频超声或CT提示锁骨上淋巴结肿大,转移可能。按检查方法不同分为高频超声组82例,CT组62例,对病例进行临床观察或行超声引导下细针穿刺细胞学检查(FNAC)明确锁骨上淋巴结性质。结果:在诊断恶性锁骨上淋巴结中,高频超声组总体符合率明显高于CT组(85.4%,58.1%),比较有统计学差异(P<0.05);FNAC阳性率高频超声组明显高于CT组(83.8%,49.0%),比较有统计学差异(P<0.05);FNAC假阴性率(7.4%,7.8%)比较无统计学差异(P>0.05)。结论:高频超声组在检查恶性肿瘤锁骨上淋巴结转移的符合率及FNAC阳性率方面均优于CT组,高频超声可作为锁骨上淋巴结肿大的首选检查,FNAC是鉴别锁骨上淋巴结良恶性的主要方法,但仍有一定的假阴性率。

Objective ：To study the application value of high frequency ultrasound and computed tomography （CT） in diagnosis of malignant supraclavicular nodes. Methods：The data of 144 patients with malignant tumors were retrospective analyzed in The Yixing Affiliated Hospital of Jiangsu University, who were diagnosed with supraclavicular nodes enlargement, maybe metastasis. All the patients were divided into two groups ,82 patients in ultrasound group ,62 patients in CT group. The nature of supraclavicular nodes were performed by fine needle aspiration cytodiagnosis （FNAC） or clinical observation. Results：The general coincidence rate in ultrasound group was apparently higher than in CT group（85.4% ,58.1% ）,had significant difference （P 〈 0.05 ）. The positive rate of FNAC in ultrasound group was apparently higher than in CT group（83.8% ,49.0% ）, had significant difference （ P 〈 0.05 ）. The false negative rate between two groups （7.4% ,7.8 % ） had no significant difference （ P 〉 0.05 ）. Conclusion ： The general coinci- dence rate and positive rate of FNAC in ultrasound group were superior to CT group. High frequency ultrasound could be the first choice for enlarged supraclavicular nodes detection. FNAC was the major method for identification of be- nign or malignant lymph nodes, but still had certain false negative rate.