scholarly journals Ultrasound-guided fine needle aspiration cytology of Para-aortic lymph node metastasis in uterine cervical cancer: diagnostic accuracy and impact on clinical decision making

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junping Liu ◽  
Xin Liu ◽  
Zhengying Guo ◽  
Xiaojuan Lv ◽  
Weimin Mao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Needle Aspiration ◽  
Uterine Cervical Cancer ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Aortic Lymph Node ◽  
Needle Aspiration Cytology

Abstract Objective The main aim of this study was to ascertain the effectiveness of ultrasound-guided fine needle aspiration cytology (US-FNAC) in the diagnosis of para-aortic lymph node (PALN) metastasis in uterine cervical cancer and to establish its potential impact on clinical therapeutic decision making. Methods We retrospectively reviewed clinical data from 92 patients diagnosed with cervical cancer with PALN enlargement between 2010 and 2018. Cytological results obtained with US-FNAC were classified by the same experienced cellular pathologists. Diagnostic indicators were determined on the basis of biopsy, imaging and clinical follow-up results. Univariate and multivariate analyses were used to assess the differences of influencing factors. The effect of US-FNAC on clinical decision making was evaluated. Results Cytological results of US-FNAC were categorized as malignancy (n = 62; 67.4%), suspicious malignancy (n = 11; 12.0%), undetermined (n = 5; 5.4%), benign (n = 10; 10.9%), and inadequate (n = 4; 4.3%). Satisfactory biopsy samples were obtained from 95.7% of PALNs sampled (88/92). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC in distinguishing benign from malignant cases were 90.1% (95% CI: 0.809–0.953), 100% (95% CI: 0.561–1), 100% (95% CI: 0.938–1), 46.7% (95% CI: 0.223–0.726) and 90.9% (95% CI: 0.848–0.970), respectively. Univariate analysis indicated significant differences in experience of puncture physicians (radiologists) between the correct and wrong diagnosis groups (P < 0.05), which was further confirmed as an independent predictor of diagnostic accuracy in multivariate analysis (p = 0.031, OR = 0.077, 95% CI: 0.354–0.919). All patients tolerated the US-FNAC procedure well and only nine presented slight abdominal discomfort. The therapeutic strategies for 74 patients (80.4%) were influenced by US-FNAC findings. Conclusions US-FNAC was a relatively safe and effective technique for examination of enlarged para-aortic lymph nodes and may therefore serve as a routine diagnostic tool to guide clinical decision making for management of cervical cancer.

scholarly journals US-Guided Fine-Needle Aspiration Cytology of Para-Aortic Lymph Nods Metastasis in Uterine Cervical Cancer: Accuracy and Impact on Clinical Decision Making

2021 ◽  
Author(s):  
Junping Liu ◽  
Xin Liu ◽  
Zhengying Guo ◽  
Xiaojuan Lv ◽  
Weimin Mao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Needle Aspiration ◽  
Uterine Cervical Cancer ◽  
Aspiration Cytology ◽  
Diagnosis Group ◽  
The Us ◽  
Needle Aspiration Cytology

Abstract Objective: To investigate whether ultrasound guided fine-needle aspiration cytology(US-FNAC) is an effective technique for diagnosing para-aortic lymph nodes(PALNs) metastasis in uterine cervical cancer and access the impact on clinical therapeutic decision. Methods: We retrospectively reviewed the clinical data of 92 patients with PALN enlargement in cervical cancer between 2010 and 2018. The US-FNAC cytological results were classified by the same experienced cellular pathologists. The diagnostic indicators were calculated according to biopsy , imaging and clinical follow-up results. Univariate and multivariate analysis was used to analyze the differences of influencing factors. The effect of US-FNAC on clinical decision making was evaluated. Results: The results of cytological diagnosis by US-FNAC were categorized as malignancy(n=62;67.4%), suspicious malignancy(n=11;12.0%), undetermined(n=5;5.4%), benign (n=10;10.9%), and inadequacy(n=4;4.3%). The satisfactory biopsy samples were obtained from 95.7% of PLANs (88/92). The sensitivity, specificity, PPV, NPV and accuracy of FNAC in distinguishing benign from malignant were 90.1%(95%CI:0.809-0.953), 100%(95%CI:0.561-1), 100%(95%CI:0.938-1), 46.7%(95%CI:0.223-0.726) and 90.9%(95%CI:0.848-0.970) respectively. Univariate analysis indicated that experience of the puncture physicians(radiologists) was significant differences between the correct diagnosis group and wrong diagnosis group (P<0.05); the experience was confirmed as independent predictor of diagnostic accuracy by multivariate analysis (p=0.031,OR=0.077,95%CI:0.354-0.919). All patients tolerated the US-FNAC procedure well and only nine patients presented slight abdominal discomfort. Through US-FNAC technique, the therapeutic methods of 74 patients (80.4%) were subjected to affect.Conclusions: US-FNAC is a relatively safe and effective examination technique for enlarged para-aortic lymph nodes, which can be considered as a routine examination before treatment of cervical cancer to guide clinical decision-making.

scholarly journals PARA-AORTIC LN INVOLVED DYSGERMINOMA MASQUERADING AS MYOMA DURING PREGNANCY: CASE STUDY

2018 ◽  
Vol 6 (6) ◽  
pp. 189-192
Author(s):  
Eun hyun Lee ◽  
Yong-Il Ji
Keyword(s):  
Adult Life ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Aortic Lymph Node ◽  
Early Adult Life ◽  
Malignant Germ Cell Tumor ◽  
Ovarian Dysgerminoma ◽  
Needle Aspiration Cytology

Ovarian dysgerminoma is a malignant germ cell tumor and it account for 1-5% of all ovarian cancers. Dysgerminoma usually occurs in adolescence and early adult life. So, it could cause problems in fertility and if it is diagnosed during pregnancy, feto-maternal problems will be incurred. Hereby, we report a case of successful delivery associated with para-aortic Lymph Node (LN) involved ovarian dysgerminoma masquerading as myoma during pregnancy and recommend ultrasound guided fine needle aspiration cytology for ovarian masses should be considered.

scholarly journals Diagnostic Algorithm for Metastatic Lymph Nodes of Differentiated Thyroid Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1338
Author(s):  
Sae Rom Chung ◽  
Jung Hwan Baek ◽  
Young Jun Choi ◽  
Tae-Yon Sung ◽  
Dong Eun Song ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Diagnostic Algorithm ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Malignancy Rate ◽  
Needle Aspiration Cytology ◽  
Ultrasound Features

We aimed to evaluate appropriate strategies for interpreting fine-needle aspiration cytology (FNAC) and thyroglobulin concentrations obtained through aspiration (FNA-Tg) results based on the sonographic features of lymph nodes (LNs). Consecutive patients who underwent ultrasound-guided FNAC and FNA-Tg for metastatic LNs from differentiated thyroid carcinomas (DTCs) from January 2014 to December 2018 were reviewed retrospectively. LNs were categorized sonographically as suspicious, indeterminate, or benign. The optimal FNA-Tg cutoff for metastatic LNs was evaluated preoperatively, after lobectomy, and after total thyroidectomy. The diagnostic performances of FNA-Tg, FNAC, and their combination were analyzed based on the sonographic features of LNs. The malignancy rates of LNs were analyzed based on the sonographic features, FNAC, and FNA-Tg results. Of the 1543 LNs analyzed, 528 were benign, whereas 1015 were malignant. FNA-Tg increased the sensitivity and accuracy of FNAC for LNs. The malignancy rate of LNs found to be malignant by FNAC or elevated FNA-Tg ranged from 82% to 100%, regardless of the sonographic features. The malignancy rate of LNs with indeterminate or benign FNAC findings and low FNA-Tg were stratified according to their sonographic features. We propose a diagnostic algorithm, based on combined FNAC, FNA-Tg, and ultrasound features of LNs, for diagnosing metastatic LNs of DTCs.

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