Abstract
ObjectivesDifferentiation of benign and malignant changes in lymph nodes is extremely important. We aimed to identify the ultrasound and clinical diagnostic criteria permitting this differentiation.MethodsClinical and ultrasound data were collected at Beijing Friendship Hospital from May 2019 to November 2020. Univariate and multivariate analysis were performed using statistical methods, and a mathematical model was established to evaluate benign and malignant lymph nodes.ResultsA total of 1343 LNs (person) with US‐guided core needle or fine needle biopsy (CNB or FNB) were evaluated in the analysis. Variables with a high predictive power were sex (odds ratio, OR: 3.360, p<0.001), short diameter (OR: 4.660, p<0.001), short/long diameter (S/L) ratio (OR: 1.515, P=0.007), border (OR: 1.626, p=0.002), cortex echogenicity (OR: 2.089, P<0.001), fusion (OR: 2.313, p=0.002), vascularity (peripheral vascularity, OR: 3.424, p<0.001; mixed vascularity, OR: 4.127, p<0.001), and medical history (fever/local pain, OR: 0.316, p<0.001; tumor history in the drainage area, OR: 4.595, p<0.001; both, OR: 5.554, p<0.001). The cut-off score on receiver operating characteristic (ROC) curve analysis using these eight variables was 2.5. The largest area under the ROC curve (Az) value was 82.3% (95% confidence interval (CI), 0.805–0.851), and the sensitivity (79.4%), specificity (72.3%), and accuracy (74.8%) were higher than those for nearly all the single indices.ConclusionThe model of combination of ultrasound and clinical symptoms can preliminarily evaluate the benign and malignant of lymph nodes.
Highlights
Lymph nodes (LNs) are an important part of the human immune system
Clinical and ultrasound data were collected at Beijing Friendship Hospital from May 2019 to November 2020
The largest area under the receiver operating characteristic (ROC) curve (Az) value was 82.3% (95% confidence interval (CI), 0.805–0.851), and the sensitivity (79.4%), specificity (72.3%), and accuracy (74.8%) were higher than those for most the single indices
Summary
Lymph nodes (LNs) are an important part of the human immune system. The human body contains approximately 800 LNs [1], and more than one-third of these are located in superficial areas. LNs participate in the immune process by filtering out the lymph. In organs or regions showing pathological changes, bacteria, toxins, parasites, or cancer cells can enter the corresponding local. LNs. LNs clear or block harmful factors by proliferating, increasing in volume, or showing changes in shape and architecture. The lymphatic system itself can show pathological changes. Malignant cells in the LNs proliferate and multiply, which can squeeze the normal structures and increase the volume of LNs. identification and characterization of benign and malignant changes in LNs is of great clinical significance
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