ABSTRACT
Objective To evaluate the diagnostic value of lymph node fine-needle aspiration (FNA)Epstein-Barr virus (EBV)-DNA concentration detection in nasopharyngeal carcinoma (NPC) cervical lymph node metastasis.Methods From August to December 2016,36 cases of NPC and 9 cases of other tumors (not correlated with EBV infection) were enrolled in this study at the Sun Yat-sen University Cancer Center.All patients received magnetic resonance images (MRI),plasma and cervical lymph node FNA EBV-DNA detection.Results The median concentration of EBV-DNA in FNA fluid (1.39 × 105 copies/ml) in cervical lymph node metastasis was significantly higher than that in plasma (2.00 × 103 copies/ml),with a significant difference (x2 =16.723,P =0.004).The diagnosis sensitivity,specificity,accuracy of the lymph node FNA fluid of EBV-DNA were 86.2％ (25/29),71.4％ (10/14) and 81.4％ (35/43) respectively,which were better than those of MRI [72.4％ (21/29),50.0％ (7/14) and 65.1％ (28/43) respectively] and plasma EBV-DNA [55.2％ (16/29),71.4％ (10/14) and 60.5％ (26/43) respectively].The area under the curve (AUC) of level Ⅰ b cervical lymph node metastasis was calculated,and FNA fluid EBV-DNA (AUC =0.688)was better than MRI (AUC =0.583),with a significant difference (Z =2.476,P =0.008).The EBV-DNA concentration in FNA fluid in cervical lymph node metastasis of patients with other tumors (no correlated with EBV infection) was 0 copy/ml.Conclusion FNA fluid EBV-DNA may improve the diagnostic sensitivity of cervical lymph node metastasis in nasopharyngeal carcinoma,and help to explore the clinical target volume neck nodes at level Ⅰ b cervical lymph node in radiotherapy.
ABSTRACT
Objective To evaluate the efficiency of thyroid ultrasound grading formulated by American Thyroid Association (ATA) and fine-needle aspiration (FNA) biopsy in diagnosing benign and malignant thyroid nodules.Methods A retrospective analysis of 357 thyroid nodules in 342 patients underwent surgical excision or FNA biopsy after thyroid ultrasound was performed.All ultrasonograms were graded according to ATA diagnosis guideline for thyroid nodule versi on 2015.The diagnostic efficiency of ATA grading and FNA biopsy were evaluated comparing with postoperative pathological results.Results There were 248 of 357 thyroid nodules confirmed with postoperative pathology,including 233 malignant and 15 benign nodules.The diagnostic accuracy,sensitivity,specificity,positive and negative predictive value of ATA guideline in diagnosis of malignant thyroid nodules was 88.31％ (219/248),90.99％ (213/233),46.67％ (7/15),96.36％ (212/220)and 25.00％ (7/28),respectively,while of FNA biopsy was 98.81％ (83/84),100％ (75/75),88.89 ％ (8/9),98.68％ (75/76) and 100％ (8/8),respectively.The area under the curve (AUC) of ROC was 0.653 and 0.944 for ATA grading and FNA biopsy,respectively (Z=2.397,P=0.017).Conclusion ATA guideline has high diagnostic value in differential diagnosis of thyroid nodules,while FNA may be more effective in diagnosis of thyroid nodules.