超声引导下粗针穿刺诊断颈部淋巴瘤的准确性分析

Diagnostic Accuracy in Cervical Lymphoma by Ultrasound-guided Core Needle Biopsy

目的:探讨超声引导下粗针穿刺活检(UGCNB)在颈部淋巴瘤诊断中的应用价值。方法:收集UGCNB的颈部淋巴瘤41例,观察粗针穿刺活检标本的病理形态,对比研究与之相应的手术切除标本的病理检查结果。结果:通过HE染色、免疫组化染色和/或原位杂交技术(ISH),穿刺标本确诊或基本确诊32例(78.0%);提出倾向性诊断7例(17.1%);诊断阳性率(或称敏感性)为95.1%(39/41),能正确判断良、恶性者34例,特异性达87.2%(34/39),假阴性诊断率为2.6%(1/39),无假阳性诊断。4例明确了病变性质,但不能分亚型,诊断准确率为76.9%(30/39)。其中B细胞非霍奇金淋巴瘤(B-NHL)准确率为83.3%(25/30),T细胞非霍奇金淋巴瘤(T-NHL)准确率为66.7%(4/6)。结论:超声引导下粗针穿刺诊断颈部淋巴瘤尤其对于具有单一瘤细胞形态的B-NHL和T-NHL有较高的准确率。

Objective:To discuss the diagnostic accuracy in cervical lymphoma by ultrasound-guided core needle biopsy(UGCNB).Methods:Prospective study was performed,and the diagnosis of 41 cases of UGCNB specimens were compared with the final diagnosis obtained by surgically-removed specimen.Results:By using the routine haematoxylin-eosin staining,immunohistochemistry and/or in situ hybridization(ISH),39 cases were determined to be adequate for pathological diagnosis,the sensitivity was 95.1%(39/41);32out of 39cases(78.0%)were arrived at a specific diagnosis,7(17.1%)cases got the suggestive diagnosis.Compared to the final diagnosis,34 cases were correct in differentiating benign from malignant nature of the lesion,and the specificity was 87.2%(34/39).And 4cases with nature determination could not be classified into a definitive pathological subtype.Pseudo-negative diagnosis accounted for 2.6%(1/39),and no pseudo-positive diagnosis.The overall accuracy was 76.9%(30/39),of which the accuracy of B cell nonHodgkin’s(B-NHL)was 83.3%(25/30),the accuracy of T cell non-Hodgkin’s(T-NHL)was 66.7%(4/6).Conclusion:The pathological diagnosis on ultrasound-guided core needle biopsy in cervical lymph nodes has high accuracy,especially to the B-NHL and T-NHL whose tumor cell morphology was relatively single histologically.