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彩色多普勒超声结合针吸细胞学检查在宫颈癌腹股沟淋巴结复发转移中的诊断价值

The value of ultrasonography combined with ultrasound guided fine needle aspiration cytology in the diagnosis of inguinal lymph node metastasis in cervical carcinoma

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【作者】 郑秋青陈丽羽时开元金鑫焱王立平谢发君

【Author】 Zheng Qiuqing;

【机构】 浙江省肿瘤医院超声科

【摘要】 目的 评价彩色多普勒超声(Color doppler ultrasonography,CDU)结合超声引导下针吸细胞学检查(Ultrasound guided fine needle aspiration cytology,US-FNAC)在宫颈癌治疗后患者腹股沟淋巴结复发转移中的诊断价值。方法 对308例宫颈癌治疗后患者的580枚腹股沟淋巴结行CDU检查,记录其形态、内部回声、皮髓质结构、淋巴门结构及内部血流状况等超声图像特征,并将其诊断结果和US-FNAC的结果相对比,评价超声诊断宫颈癌腹股沟淋巴结复发转移的准确性。结果580枚淋巴结中566枚取材满意,78枚淋巴结为转移性淋巴结。转移性与非转移性腹股沟淋巴结的形态、内部回声、皮髓质结构、淋巴门结构及内部血流状况等超声表现差异均有统计学意义(p<0.05),表现为类圆形或融合状、内部均匀低回声、皮髓质结构不清、淋巴门消失或偏心性、血流丰富的淋巴结具有复发转移倾向,其诊断准确率分别为90.8%、82.3%、80.6%、58.7%、67.0%。结论 宫颈癌治疗后患者的复发转移性腹股沟淋巴结在形态、内部回声、皮髓质结构、淋巴门结构及内部血流等方面均有显著的特征性,US-FNAC可进一步对腹股沟淋巴结的病理性质作出判断,提高诊断的准确性。

【Abstract】 Objective To evaluate the ultrasonography(US) combined with Ultrasound guided fine needle aspiration cytology(US-FNAC) in the diagnosis of inguinal lymph node metastasis in cervical carcinoma after initial treatment.Methods 580 inguinal lymph nodes from 308 patients with cervical carcinoma were studied by US and US-FNAC after initial treatment,and the ultrasonic feature was analyzed.Results 566 lymph nodes were successful cytology from total of 580 cases,and 78 lymph nodes were pathological metastatic.There were significant differences in the shape,internal echoes,lymph hilum,corticomedullary structure and flow pattern between malignant and benign inguinal lymph nodes(P<0.05).The round of fused shape,internal hypoehcocity,vague corticomedullary structure,hilum deformation and abundant flow were mainly observed in metastatic lymph nodes,and the diagnostic accuracy for metastatic lymph nodes were 90.8%、 82.3%、 80.6%、 58.7%、 67.0%,respectively.Conclusion US combined with US-FNAC is useful diagnosis of inguinal lymph node metastasis in cervical carcinoma.

【基金】 中国博士后基金(2012M521189);浙江省博士后择优专项基金(Bsh1202064)
  • 【文献出处】 浙江临床医学 ,Zhejiang Clinical Medical Journal , 编辑部邮箱 ,2014年10期
  • 【分类号】R445.1;R737.33
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