高频超声诊断下咽鳞癌淋巴结转移的临床研究

目的 探讨高频超声在诊断下咽鳞癌颈淋巴结转移的应用价值。 方法 收集于耳鼻咽喉科接受颈淋巴结清扫术的47例下咽鳞状细胞癌患者的临床资料,以病理检查结果为金标准,对颈部触诊、颈部强化CT、高频超声检查结果,以kappa值反映三种方法结果与金标准的一致程度,以灵敏度、特异度评价三种检查方法的诊断效果;用Pearson χ2检验比较三种方法的灵敏度和特异度。 结果 研究纳入下咽癌患者47例,所有患者均无远处转移病灶。三种检查方法,超声检查与病理检查的一致性最好(Kappa=0.718)。以术后病理检查结果为准,对于下咽癌颈淋巴结转移,超声诊断的灵敏度最高(91.9%)、高于触诊,差异有统计学意义;超声灵敏度也有高于强化CT(78.9%)的趋势,但差异无统计学意义。在特异度方面,触诊最高(94.74%)、超声(78.95%)次之、强化CT(61.11%)最低,三者的差异均无统计学意义。 结论 对于诊断下咽癌颈淋巴结转移,高频超声检查具有较高的灵敏度及特异度,可为临床诊断及所采用的手术方式提供重要信息,因其无创、便携、可重复等优点,可作为监测下咽癌颈部淋巴结转移的重要辅助手段。

Clinical value of high-frequency ultrasound in the diagnosis of lymph node metastasis in hypopharyngeal squamous cell carcinoma

Objective To evaluate the clinical value of high-frequency ultrasound in the diagnosis of cervical lymph node metastasis in hypopharyngeal squamous cell carcinoma. Methods Forty-seven patients with hypopharyngeal cancer who underwent neck lymph node dissection in the Department of Otolaryngology in Qilu Hospital of Shandong University were recruited. The postoperative pathological results were used as the gold standard. The Kappa value was used to reflect consistency between the results of the three methods and the gold standard, and sensitivity and specificity were used to evaluate the diagnostic effect of the three methods; Pearson's chi-square test was used to compare the sensitivity and specificity of the three methods. Results A total of 47 patients with hypopharyngeal cancer, all of whom had no distant metastasis, were included in the study. Among the three methods, the consistency between ultrasound and pathological examination was highest(Kappa=0.718). According to the postoperative pathological examination results, the sensitivity of ultrasound in the diagnosis of cervical lymph node metastasis in hypopharyngeal cancer was highest(91.9%). The sensitivity was higher than that of palpation, and the difference was statistically significant. The sensitivity of ultrasound also tended to be higher than that of enhanced CT(78.9%), but the difference was not statistically significant. Palpation showed the highest specificity(94.74%), followed by ultrasound(78.95%)and enhanced CT(61.11%); however, the difference was not statistically significant. Conclusion High-frequency ultrasonography has high sensitivity and specificity in the diagnosis of cervical metastatic lymph nodes in hypopharyngeal carcinoma, which has important implications for clinical diagnosis. As it is non-invasive, portable, and repeatable, high-frequency ultrasound can be used as a common clinical examination method for cervical lymph node metastasis in hypopharyngeal carcinoma.