B超检查耳鼻咽喉恶性肿瘤伴颈部淋巴结转移诊断中的作用  

Contributions of B-ultrasonography in Diagnosis of Cervical Lymph Node Metastasis of Malignant Tumors of Ear, Nose and Throat

作　　者：张瑞华 

机构地区：湖南省浏阳市人民医院,430100

出　　处：《中外健康文摘：医药月刊》2008年第5期157-159,共3页

摘　　要：目的：探讨B超在辅助诊断耳鼻咽喉恶性肿瘤伴颈淋巴结转移中的作用。方法：回顾63例耳鼻咽喉恶性肿瘤病人的颈部触诊、B超检查和病理诊断资料，将颈部触诊和B超检查结果与术后病理诊断相对照。计算颈部触诊和B超检查的敏感性、特异性和准确性，用χ2检验进行统计学分析。结果：颈部触诊的敏感性、特异性和准确性分别为62．50％、70.27％和66．67％；B超诊断的敏感性、特异性和准确性分别是96．89％、35．14％和63．76％。两种方法的敏感性和特异性的比较经χ2检验有显著性差异（χ2=11．68，p〈0．05；χ2=9．16，P〈0．05）。结论：B超检查诊断颈淋巴结恶性肿瘤转移敏感性较临床触诊高，但特异性较临床触诊低。B超检查可弥补临床触诊敏感性不高的缺陷，当颈部触诊未及淋巴结肿大，而B超检查发现淋巴结长径〉10mm，或长径与短径的比值（L／s）〈2，或淋巴结回声不均，门部结构破坏时，应充分注意。Obstructive： To discuss the contributions of B-ultrasonography in diagnosing cervical Lymph node metastasis of malignant tumors of ear, nose and throat. Methods： The available clinical data of 63 patients with malignant tumors of ea, nose and throat were reviewed. Their documents of cervical palpation, B-ultrasonography and pathologic examination were retrospectively analyzed. The difference of sensitivity, specificity and accuracy between cervical palpation and B-ultrasonography were statistically analyzed by Z2 test. Results： We found the sensitivity, specificity and accuracy of cervical palpation were 62.50%, 70.27% and 66.67% respectively while the sensitivity, specificity and accuracy of B-ultrasonography were 96.89%, 35.14% and 63.76% respectively. The difference of sensitivity between cervical palpation and B-ultrasonography was statistically significant （x2=11. 68, p〈0. 05）, and the same was the difference of specificity between cervical palpation and B-ultrasonog r（x2=9. 16, P〈0. 05）. Conclusion： In respect of diagnosing cervical lymph node metastasis of malignant tumors of ear, nose and throat, our preliminary findings revealed that the sensitivity of B-ultrasonography was higher than that of cervical palpation while the specificity of B-ultrasonography was lower than that of cervical palpation. This indicates that B-ultrasonography can make up some deficiencies of cervical palpation such as low sensitivity. A high index of suspicion should be kept and sufficient attention should be paid in case a cervical lymph node is nonpalpable, however, the measurements of B-ultrasonography meet one of following criteria： （1） The longest diameter is more than 10 mm, （2） The ratio of long- to shortaxis diameter （L/S） is less than 2, or（3） The nodal holus is destroyed or internal echo structure is heterogeneous pattern.

关 键 词：转移 颈淋巴结 B超 

分 类 号：R739.6[医药卫生—肿瘤;医药卫生—临床医学]