超声引导下穿刺活检联合免疫组化在浅表淋巴结疾病中的诊断价值

Diagnostic value of ultrasound-guided needle biopsy combined with immunohistochemistry in superficial lymph node diseases

目的:探讨超声引导下穿刺活检联合免疫组化在浅表淋巴结疾病中的诊断价值。方法:回顾性分析2018年1月—2021年6月在汕头大学医学院第二附属医院行超声引导下经皮浅表淋巴结穿刺活检术的395例患者的临床资料。以临床最终诊断结果为参考标准,评价穿刺活检联合免疫组化对浅表淋巴结良恶性的诊断效能以及有效诊断率。结果:浅表淋巴结穿刺活检的最终临床诊断结果为良性淋巴结病变199例,淋巴瘤40例,转移性癌156例。超声引导下穿刺活检联合免疫组化诊断浅表淋巴结良恶性的敏感性、特异性、阳性预测值、阴性预测值分别为98.47%、100%、100%、98.51%。良性淋巴结、淋巴瘤和转移癌病例中穿刺活检联合免疫组化组的有效诊断率均高于单纯活检组的有效诊断率,差异有统计学意义(P值均<0.05)。结论:超声引导下穿刺活检联合免疫组化对浅表淋巴结良恶性的鉴别有较高的诊断价值,能够明确浅表淋巴结病变的病理分型和病灶来源,为临床提供明确的诊断信息。

Objective:To investigate the diagnostic value of ultrasound-guided needle biopsy combined with immunohistochemistry in superficial lymph node diseases.Methods:The clinical data of 395 patients who underwent ultrasound-guided percutaneous superficial lymph node biopsy in the Second Affiliated Hospital of Shantou University School of Medicine from January 2018 to June 2021 were retrospectively analyzed.The diagnostic efficacy of needle biopsy combined with immunohistochemistry for the diagnosis of benign and malignant superficial lymph nodes and the effective diagnostic rate were evaluated using the final clinical diagnosis as the reference standard.Results:The final clinical diagnosis of superficial lymph node biopsy was 199cases of benign lymph node lesions,40 cases of lymphoma,and 156 cases of metastatic carcinoma.The sensitivity,specificity,positive predictive value,and negative predictive value of ultrasound-guided needle biopsy combined with immunohistochemistry in the diagnosis of benign and malignant superficial lymph nodes were 98.47%,100%,100%,and 98.51%,respectively.In benign lymph node,lymphoma and metastatic cancer cases,the effective diagnosis rate of needle biopsy combined with immunohistochemistry group was higher than that of simple biopsy group,and the difference was statistically significant(all P<0.05).Conclusion:Ultrasound-guided needle biopsy combined with immunohistochemistry has a high diagnostic value in the identification of benign and malignant superficial lymph nodes,and can clarify the pathological classification and source of superficial lymph node lesions,and provide clear diagnostic information for clinical use.