【摘要】 目的探讨高频彩超诊断口腔鳞状细胞癌(OSCC)患者发生颈部淋巴结转移的临床价值,分析高频彩超影像特征与OSCC患者发生颈部淋巴结转移的相关性。方法选择95例接受手术治疗并行颈部淋巴结清扫术的OSCC患者,术前均采用高频彩超检查颈部淋巴结。以术后病理诊断结果为金标准,评价高频彩超对颈部淋巴结转移的诊断效能,并采用Logistic回归模型分析超声特征与OSCC患者发生转移性颈部淋巴结的相关性。结果高频彩超诊断OSCC患者发生颈部淋巴结转移的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为81.7%、71.6%、76.1%、69.8%及83.0%。高频彩超和病理诊断结果诊断OSCC患者发生颈部淋巴结转移的一致性呈中等水平(Kappa值=0.537,P<0.05)。Logistic回归分析结果显示,颈部淋巴结内部中高回声、淋巴门缺失、有钙化、周边型或混合型血流及阻力指数增高与OSCC患者发生颈部淋巴结转移相关(均P<0.05)。结论高频彩超对OSCC患者发生颈部淋巴结转移的诊断具有一定价值;内部回声、淋巴门缺失与否、是否发生钙化、血流分型和阻力指数等超声影像特征与OSCC患者发生颈部淋巴结转移密切相关。更多还原

【Abstract】 Objective To investigate the clinical value of high-frequency color Doppler ultrasonography in the diagnosis of the incidence of cervical lymph node metastasis in patients with oral squamous cell carcinoma(OSCC), and to analyze the correlation of the image characteristics of high-frequency color Doppler ultrasonography with the incidence of cervical lymph node metastasis in OSCC patients. Methods Ninety-five patients with OSCC who received surgical treatment and cervical lymph node dissection were enrolled and underwent preoperative cervical lymph node examination by high-frequency color Doppler ultrasonography. With the results of postoperative pathological diagnosis as the gold standard, the diagnostic efficacy of high-frequency color Doppler ultrasonography for cervical lymph node metastasis was assessed, and the correlation between ultrasonic characteristics and incident metastatic cervical lymph node was analyzed in OSCC patients by using the Logistic regression model. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of high-frequency color Doppler ultrasonography for diagnosing incident cervical lymph node metastasis were 81.7%, 71.6%, 76.1%, 69.8% and 83.0%, respectively. A moderate-level consistency existed between high-frequency color Doppler ultrasonography and pathological results for diagnosing incident cervical lymph node metastasis in OSCC patients(Kappa value=0.537, P<0.05). Logistic regression analysis results showed that isoecho to hyperecho inside cervical lymph nodes, absence of echogenic hilum, presence of calcification, peripheral or mixed blood flow, and increased resistance index correlated with incident cervical lymph node metastasis in OSCC patients(all P<0.05). Conclusion High-frequency color Doppler ultrasonography has a certain diagnostic value for incident cervical lymph node metastasis in OSCC patients; echo inside, absence of echogenic hilum, presence of calcification, blood flow classification, resistance index, and other features of ultrasonographic image are closely related to developing cervical lymph node metastasis in OSCC patients.更多还原