B超检查和触诊对肺癌锁骨上淋巴结转移的诊断价值  

The significance of B-ultrasound and palpation in diagnosing supraclavicular lymph node metastasis of lung cancer

作　　者：马茂[1] 王小林[1] 马振华[1] 

机构地区：[1]西安交通大学医学院第一附属医院老年外科,西安710061

出　　处：《陕西医学杂志》2009年第1期67-68,71,共3页Shaanxi Medical Journal

摘　　要：目的:比较B超和触诊在原发性肺癌锁骨上淋巴结转移诊断中的价值,提高术前原发性肺癌TNM分期诊断的准确性。方法:对68例有组织病理学证据的原发性肺癌患者进行了锁骨上淋巴结触诊和B超检查,并对肿大淋巴结行B超引导下细针穿刺细胞学检查。将细胞学诊断作为淋巴结转移的诊断标准,比较触诊和B超检查在发现锁骨上淋巴结肿大中的区别。结果:在68例肺癌患者中,有24例(35.3%)被确诊为锁骨上淋巴结细胞学转移。其中15例小细胞肺癌中有7例,占46.7%;53例非小细胞肺癌中有17例,占32.1%。超声检查的准确度(1.00;24∶24,95%CI:0.82,1.00)明显高于触诊(0.46;11∶24,95%CI:0.31,0.61)。结论:对于原发性肺癌的锁骨上淋巴结检查单纯靠触诊有漏诊的可能,B超检查可以增加锁骨上淋巴结转移的检出率。Objective：To explore the significance of B-ultrasound and palpation in diagnosing supraclavieular lymph node metastasis of lung cancer, with a view to improving the accuracy of preoperative TNM staging. Methods：68 cases of primary lung cancer underwent supraclavicular lymph nodes palpation and ultrasound examination, as well as B-guided fine needle aspiration was performed in swollen lymph nodes. Comparing palpation and ultrasound examination, the difference of the accuracy in diagnosing supraclavicular lymph node metastasis was calculated. Results ：Of the 68 patients with lung cancer, 24 patients （35.3%） were identified with supraclavicular lymph node metastasis. In 15 cases of small cell lung cancer, 7 cases （46.7%） existed supraclavicular lymph node metastasis. In 53 cases of non-small cell lung cancer, 17 eases （32. 1%） existed supraclavicular lymph node metastasis. Ultrasound accuracy （1.00; 24 ： 24,95% CI ： 0.82, 1.00） was significantly higher than palpation （0.46; 11 ： 24,95% CI ： 0. 31,0.61） in finding supraclavicular lymph node metastasis. Conclusion：Ultrasound examination can increase the detectable rates of supraclavicular lymph node metastasis of lung cancer as comparing with palpation.

关 键 词：肺肿瘤/诊断 超声检查 活组织检查 针吸 触诊 对比研究 

分 类 号：R735.105[医药卫生—肿瘤] R734.2[医药卫生—临床医学]