경부 림프절 진단에서 초음파 유도하 세침흡인검사와 중심바늘생검의 유용성 비교
Comparison of Usefulness of Ultrasound-Guided Fine Needle Aspiration and Core Needle Biopsy in Diagnosis of Cervical Lymphadenopathy
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Background and Objectives The purpose of this study is to compare diagnostic outcomeand safety of fine needle aspiration (FNA) and core needle biopsy (CNB) in patients with cervicallymphadenopathy. Subjects and Method This retrospective studies were conducted on 164 cases with cervicallymphadenopathy that had undergone FNA, and 44 cases that had undergone CNB. The cytopathologicalresults from FNA and CNB were compared with the histopathological resultsconfirmed by excisional biopsy in the nodes according to different sizes and radiological levels,respectively. Diagnostic sensitivity, specificity, positive predictive value (PPV), negativepredictive value (NPV), and accuracy were evaluated according to disease entities. Results FNA is more accurate than CNB in most of the sizes and at all cervical levels. However,there is no statistically significant difference between the results of the two tests. Sensitivityand NPV for diagnosis of malignant lymphoma are higher with FNA than with CNB. However, specificity and PPV for malignant lymphoma are higher with CNB than with FNA. Also CNB showed superior sensitivity, PPV and NPV for metastatic lymphadenopathy. Conclusion Although CNB is beneficial in reducing the false negative rate, it still has severallimitations. Since CNB has no statistically significant advantage over FNA, FNA can bea good alternative method with less complication and high diagnostic value for lesions whereCNB is difficult to perform.
Abstract
Background and Objectives The purpose of this study is to compare diagnostic outcomeand safety of fine needle aspiration (FNA) and core needle biopsy (CNB) in patients with cervicallymphadenopathy. Subjects and Method This retrospective studies were conducted on 164 cases with cervicallymphadenopathy that had undergone FNA, and 44 cases that had undergone CNB. The cytopathologicalresults from FNA and CNB were compared with the histopathological resultsconfirmed by excisional biopsy in the nodes according to different sizes and radiological levels,respectively. Diagnostic sensitivity, specificity, positive predictive value (PPV), negativepredictive value (NPV), and accuracy were evaluated according to disease entities. Results FNA is more accurate than CNB in most of the sizes and at all cervical levels. However,there is no statistically significant difference between the results of the two tests. Sensitivityand NPV for diagnosis of malignant lymphoma are higher with FNA than with CNB. However, specificity and PPV for malignant lymphoma are higher with CNB than with FNA. Also CNB showed superior sensitivity, PPV and NPV for metastatic lymphadenopathy. Conclusion Although CNB is beneficial in reducing the false negative rate, it still has severallimitations. Since CNB has no statistically significant advantage over FNA, FNA can bea good alternative method with less complication and high diagnostic value for lesions whereCNB is difficult to perform.
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