Real-time Ultrasound-Guided Needle Biopsy in the Diagnosis of Malignant Cervical Lymphadenopathies
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 116
- 试验地点
- 1
- 主要终点
- time of needle biopsy to final diagnosis
研究概览
简要总结
The objective of the present study was to compare ultrasound (US) characteristics and ultrasound-guided core-needle biopsy (US-CNB) with US-guided fine-needle aspiration (US-FNA) in the assessment of different malignant cervical lymphadenopathies. Patients with malignant cervical lymphadenopathie with either US-FNA or US-CNB over a 3-year period from 2007 July to 2010 Dec were retrospectively reviewed. There are two major study groups according to the treatment status of the patient's population, including patients who had pathology proofed previous cancer and with clinically cervical lymphadenopathies after treatment. The second group included patients with cervical lymphaenopathies but without previous diagnosis of malignancy and treatment. The results of cytology, or pathology and time of needle biopsy to final diagnosis were traced and recorded. Morphologic US parameters and vascular features were thoroughly evaluated and compared in different disease.
详细描述
Introduction
In the absence of infection signs, lateral neck lymphadenopathies should be suspected as metastatic carcinoma or lymphoma until proved otherwise. Previously, the most commonly used sampling techniques in the head and neck are the open excisional biopsy and fine-needle aspiration (FNA) cytology. Open biopsy and lymph node excision provides material suitable for histological analysis but is invasive and may entail general anesthesia and hospital admission. Besides, excisional and incisional biopsy of cervical metastases results in a 2-3 times increased incidence of local treatment failure when compared with FNA cytology.
High-resolution ultrasound is widely used imaging modality to evaluate the morphology, internal architecture, size and shape of cervical lymph nodes. In the head and neck, the image guidance technique most commonly used has been ultrasound. The real-time capability and ease of use makes ultrasound the procedure of choice. The evidence of improved efficacy of ultrasound-guided FNA over palpation-guided FNA in the head and neck also has been well documented, leading to its acceptance as the standard procedure.
Disadvantages of FNA include a high rate of nondiagnostic samples and incomplete classification of lymphoma with delayed diagnosis. The core-needle biopsy (CNB) is an alternative to the established ways of tissue sampling and used very successfully for many years. As the histologic architecture of the lesion is preserved, it provides a sample that is adequate for histopathologic and immunohistochemical examination.
To our knowledge, there was only one prospective investigation comparing ultrasound guided CNB with FNA in the head and neck region. However, the studied population was heterogeneous and case numbers were limited. The result revealed no significant difference between both methods. The objective of the present study was to compare ultrasound-guided CNB with FNA in the assessment of different malignant cervical lymphadenopathies.
研究设计
- 研究类型
- Observational
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 20 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with malignant cervical lymphadenopathie With US-FNA or US-CNB evaluation before
排除标准
- •No ultrasound exam
结局指标
主要结局
time of needle biopsy to final diagnosis
时间窗: days from needle biopsy to final diagnosis
次要结局
未报告次要终点