目的 分析308例超声引导下浅表淋巴结穿刺活检病例资料,探讨超声引导下浅表淋巴结穿刺活检在诊断肿大淋巴结性质中的临床应用价值.方法 收集2003年1月-2010年6月在南方医院肿瘤中心接受超声引导下淋巴结穿刺活检术的308例患者资料.统计其年龄、性别、淋巴结大小、部位、病理类型,分析其淋巴结大小、部位、病理类型对病理诊断结果的影响.结果 308例患者平均年龄53.4(12～87)岁,男192例,女116例.308例中,307例取材满意,组织学诊断成功率99.7%.穿刺病理结果示:恶性病变232例(75.3%),良性病变41例(13.3%),假阴性25例(8.1%),性质不确定9例(2.9%),取材不佳1例(0.3%).恶性淋巴瘤首次穿刺确诊率为82.8% (24/29).结论 超声引导下浅表淋巴结穿刺活检术安全、有效,是临床上诊断淋巴结性质不可取代的方法.采用16G粗针切割取材对以往认为需进行切除活检才可准确诊断的恶性淋巴瘤也有很好的诊断价值.%Objective To evaluate the clinical significance of ultrasound-guided needle biopsy in diagnosis of enlarged lymph nodes by analyzing the data of 308 patients who received ultrasound-guided lymph node biopsy. Methods Data of 308 patients who underwent ultrasound-guided lymph node biopsy in the Oncology Center of Nanfang Hospital from Jan. 1,2003 to Jun. 30 , 2010 were collected. The age, sex, lymph node size and location, and pathological types of the patients were analysed. Simultaneously, the influence of lymph node size, location and pathological type on pathological diagnosis was studied. Results The average age of 308 patients, including 192 males and 116 females, was 53.4 years, ranging from 12 to 87 years. There were 307 satisfactory specimens from 308 cases with which definite histological diagnosis accuracy reaching 99.7％. In 232 cases malignancy was found (75.3％) , benign lesions in 41 (13.3％), false negative was found in 25 (8.1％), and uncertain in 9 (2.9％), poor specimen in 1 (0.3％) , and the diagnosis of malignant lymphoma was found in 82.8％ of the first biopsy specimens. Conclusion Ultrasound-guided biopsy for superficial lymph node is a safe and effective method which can not be substituted in diagnosis of lymph node pathology. In addition, due to the use of l6G cutting needle, it also has better diagnostic value in the diagnosis of malignant lymphoma.
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