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Teng D, Dong C, Sun D, Liu Z, Wang H. Comparison of Ultrasound-Guided Core Needle Biopsy Under the Assistance of Hydrodissection With Fine Needle Aspiration in the Diagnosis of High-Risk Cervical Lymph Nodes: A Randomized Controlled Trial. Front Oncol 2022; 11:799956. [PMID: 35096601 PMCID: PMC8793772 DOI: 10.3389/fonc.2021.799956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/21/2021] [Indexed: 12/07/2022] Open
Abstract
A randomized comparison of ultrasound (US)-guided core needle biopsy (CNB) under the assistance of hydrodissection with fine needle aspiration (FNA) was performed to evaluate the feasibility, safety and effectiveness for the diagnosis of high-risk cervical lymph nodes. Patients from December 2018 to May 2020 were randomly assigned to the CNB group and the FNA group at a ratio of 1:1. This study protocol was approved by the Ethics Committee of our hospital and registered in the Chinese Clinical Trial Registry (ChiCTR1800019370). The feasibility of CNB for high-risk cervical lymph nodes was evaluated by observing and recording the separation success rate (SSR) and technical success rate (TSR) of the CNB group. Safety was evaluated by comparing the incidence of major complications in the two groups. The diagnostic efficacy was evaluated by comparing the diagnostic accuracy, sensitivity, and specificity of the two groups. A total of 84 patients (84 lymph nodes) were randomized into the CNB (n = 42) and FNA (n = 42) groups. All patients in the CNB group achieved successful hydrodissection and biopsy. The SSR and TSR were both 100% in the CNB group. There were no major complications during or after the process in the two groups. Compared with the FNA group, the CNB group was significantly superior in terms of diagnostic accuracy and sensitivity (100% vs. 81.0%, P = 0.009; 100% vs. 79.2%, P = 0.035, respectively). The specificity of the two groups was 100%, and there was no significant difference. Compared with FNA, CNB under the assistance of hydrodissection is a feasible and safe method but is more effective for the diagnosis of high-risk cervical lymph nodes.
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Affiliation(s)
- Dengke Teng
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Chunhui Dong
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Daju Sun
- Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zhuo Liu
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
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Lo WC, Cheng PW, Shueng PW, Hsieh CH, Chang YL, Liao LJ. A real-time prediction model for post-irradiation malignant cervical lymph nodes. Clin Otolaryngol 2017; 43:477-482. [PMID: 28981204 DOI: 10.1111/coa.12998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To establish a real-time predictive scoring model based on sonographic characteristics for identifying malignant cervical lymph nodes (LNs) in cancer patients after neck irradiation. METHODS One-hundred forty-four irradiation-treated patients underwent ultrasonography and ultrasound-guided fine-needle aspirations (USgFNAs), and the resultant data were used to construct a real-time and computerised predictive scoring model. This scoring system was further compared with our previously proposed prediction model. RESULTS A predictive scoring model, 1.35 × (L axis) + 2.03 × (S axis) + 2.27 × (margin) + 1.48 × (echogenic hilum) + 3.7, was generated by stepwise multivariate logistic regression analysis. Neck LNs were considered to be malignant when the score was ≥ 7, corresponding to a sensitivity of 85.5%, specificity of 79.4%, positive predictive value (PPV) of 82.3%, negative predictive value (NPV) of 83.1%, and overall accuracy of 82.6%. When this new model and the original model were compared, the areas under the receiver operating characteristic curve (c-statistic) were 0.89 and 0.81, respectively (P < .05). CONCLUSIONS A real-time sonographic predictive scoring model was constructed to provide prompt and reliable guidance for USgFNA biopsies to manage cervical LNs after neck irradiation.
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Affiliation(s)
- W-C Lo
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - P-W Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - P-W Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - C-H Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Y-L Chang
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - L-J Liao
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
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Ryu KH, Lee JH, Jang SW, Kim HJ, Lee JY, Chung SR, Chung MS, Kim HW, Choi YJ, Baek JH. US-guided core-needle biopsy versus US-guided fine-needle aspiration of suspicious cervical lymph nodes for staging workup of non-head and neck malignancies: A propensity score matching study. J Surg Oncol 2017. [PMID: 28650524 DOI: 10.1002/jso.24747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES To compare US-guided core-needle biopsy (USCNB) and US-guided fine-needle aspiration (USFNA) of suspicious cervical lymph nodes for staging workup of malignancies in locations other than the head and neck using propensity score matching (PSM). METHODS This retrospective cohort study included 108 patients who underwent USFNA and 1058 who underwent USCNB for suspicious cervical lymph nodes detected by imaging modalities during the staging workup for malignancies located in regions other than the head and neck. The primary outcome was defined as the inconclusive results. To evaluate the procedures according to the outcome, we performed univariate and multivariate logistic regression analyses and a 1:1 PSM of USCNB and USFNA. RESULTS There was no complication for both USFNA and USCNB. The inconclusive results were 6.5% (7/108) for USFNA and 1.6% (17/1058) for USCNB. A significantly lower rate of the inconclusive results in USCNB than in USFNA before matching was maintained after a 1:1 PSM of 103 patients from each group (before PSM, odds ratio (OR) = 4.489, 95% confidence interval (CI) [1.803-11.177], P = 0.001; after PSM, OR = 1.060, 95%CI [1.013-1.109], P = 0.012). CONCLUSIONS Because USCNB can reduce inconclusive results compared to USFNA, it could be more helpful for staging workup of malignancies in locations other than the head and neck in patients with suspicious cervical lymph nodes.
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Affiliation(s)
- Kyeong Hwa Ryu
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jeong Hyun Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Won Jang
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hwa Jung Kim
- Preventive Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ji Ye Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Department of Radiology, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sae Rom Chung
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Mi Sun Chung
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Medical Center, Seoul, Korea
| | - Hyo Weon Kim
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Jun Choi
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jung Hwan Baek
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Xia S, Wang C, Ni X, Ni Z, Dong Y, Zhan W. NONHSAT076754 aids ultrasonography in predicting lymph node metastasis and promotes migration and invasion of papillary thyroid cancer cells. Oncotarget 2017; 8:2293-2306. [PMID: 27906682 PMCID: PMC5356800 DOI: 10.18632/oncotarget.13725] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/22/2016] [Indexed: 12/31/2022] Open
Abstract
Lymph node metastasis (LNM) is the primary challenge in papillary thyroid cancer (PTC). Recurrent cancerous lymph nodes require repeated surgeries, which increases the risk for surgical complications. Thus, the evaluation of LNM before surgery is important. Ultrasonography is the most convenient way to examine cervical LNM, but the sensitivity of ultrasonography in the identification of LNM in cases of PTC is extremely low. A series of lncRNAs (long noncoding RNAs) have been reported as candidate biomarkers in a variety of tumors. This study detected the lncRNA NONHSAT076754 in PTC and analyzed the correlation of NONHSAT076754 with the clinicopathological and ultrasonographic characteristics of patients with PTC. The value of NONHSAT076754 as an auxiliary diagnostic biomarker for use along with ultrasonography in the differentiation of LNM in PTC was assessed. Additionally, the biological function of NONHSAT076754 in PTC cells was demonstrated. Our study indicated that NONHSAT076754 promotes migration and invasiveness of PTC and serves as a valuable auxiliary biomarker that can be used along with ultrasonography in the prediction of cervical LNM.
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Affiliation(s)
- Shujun Xia
- Ultrasound Department, Rui Jin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. of China
| | - Chuandong Wang
- The Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Jiao Tong University School of Medicine & Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, P. R. of China
| | - Xiaofeng Ni
- Ultrasound Department, Rui Jin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. of China
| | - Zhongxin Ni
- Ultrasound Department, Rui Jin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. of China
| | - Yijie Dong
- Ultrasound Department, Rui Jin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. of China
| | - Weiwei Zhan
- Ultrasound Department, Rui Jin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. of China
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Al Nofal A, Gionfriddo MR, Javed A, Haydour Q, Brito JP, Prokop LJ, Pittock ST, Murad MH. Accuracy of thyroid nodule sonography for the detection of thyroid cancer in children: systematic review and meta-analysis. Clin Endocrinol (Oxf) 2016; 84:423-30. [PMID: 25845503 DOI: 10.1111/cen.12786] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 02/24/2015] [Accepted: 03/27/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Thyroid ultrasound (US) is a widely used tool for evaluating thyroid nodules. Various US features have been suggested as predictors of thyroid cancer in children. OBJECTIVE To conduct a systematic review and meta-analysis to assess the diagnostic accuracy of different thyroid US features in detecting thyroid cancer in children. METHODS We searched multiple online databases for cohort studies that enrolled paediatric patients with thyroid nodules (age <21 years) and evaluated the accuracy of 12 relevant ultrasound features. Diagnostic measures were pooled across studies using a random effects model. RESULTS The search strategy yielded 1199 citations, of which 12 studies met the predefined inclusion criteria (750 nodules). The prevalence of thyroid cancer was 27·2% (40·8% in patients with a history of radiation exposure and 23·2% in patients without a history of exposure to radiation). The most common cancer was papillary thyroid cancer (86·7%). The presence of internal calcifications and enlarged cervical lymph nodes were the US features with the highest likelihood ratio [4·46 (95% CI: 1·87-10·64) and 4·96 (95% CI: 2·01-12·24), respectively] for thyroid cancer. A cystic nodule was the feature with highest likelihood ratio for benign nodules [1·96 (95% CI: 0·87-4·43)]. CONCLUSION Thyroid US features are not highly accurate predictors of benign or malignant aetiology of thyroid nodules in children. Internal calcification may predict malignancy, and cystic appearance may suggest benign aetiology.
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Affiliation(s)
- Alaa Al Nofal
- Division of Paediatric Endocrinology, Mayo Clinic, Rochester, MN, USA
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, MN, USA
| | - Michael R Gionfriddo
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
- Mayo Graduate School, Rochester, MN, USA
| | - Asma Javed
- Division of Paediatric Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Qusay Haydour
- Internal Medicine Program, Georgia Regents University, Augusta, GA, USA
| | - Juan P Brito
- Division of Diabetes, Endocrinology, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Larry J Prokop
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Siobhan T Pittock
- Division of Paediatric Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Mohammad Hassan Murad
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, MN, USA
- Division of Preventive Medicine, Mayo Clinic, Rochester, MN, USA
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Aribaş BK, Arda K, Çiledağ N, Aktaş E, Çetindağ MF. Predictive factors for detecting malignancy in central and lateral cervical lymph nodes in papillary carcinoma of the thyroid. Asia Pac J Clin Oncol 2012; 7:307-14. [PMID: 21884444 DOI: 10.1111/j.1743-7563.2011.01408.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIM To determine the factors for predicting malignant diagnosis and limitations in ultrasonography guided fine-needle aspiration cytology of central and lateral cervical lymph nodes in patients with primary differentiated thyroid papillary carcinoma. METHODS Biopsies of cervical lymph nodes were performed in 120 patients, 31 of whom had subsequent surgical diagnoses. Factors examined were patient's age and gender of the patients, location (central and lateral compartments), hypoechogenicity with loss of hilum, microcalcification, cystic feature, minimum and maximum diameters and index value (minimum/maximum diameter). RESULTS The mean minimum diameter and index value of the lymph nodes were 9.9 ± 4.9 mm and 0.60 ± 0.19, respectively. Microcalcifications and cystic parts were specific findings with rates of 93.9% and 95.1%, respectively. Microcalcification, cystic feature, minimum diameter and index value were poor predictors of malignancy. The predictors were central location (P = 0.031) and hypoechogenicity with loss of hilum in lateral neck (P = 0.019). Central nodes led to a major problem for biopsy success due to postoperative changes and anatomic position. Nondiagnostic (30%) nodes were therefore mostly central. CONCLUSION The involvement of the central neck should be a major indication of lymph node biopsy and pathological diagnosis regardless of the imaging findings. In the lateral compartment, hypoechogenicity with loss of hilum, microcalcifications, cystic parts and an index value ≥ 0.51 are indications of a lymph node biopsy to rule out malignancy.
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Affiliation(s)
- Bilgin Kadri Aribaş
- Department of Radiology, Dr Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital, Ankara, Turkey.
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