Endoscopic ultrasonography features of malignant mediastinal and abdominal lymphadenopathy
10.3760/cma.j.cn321463-20210413-00244
- VernacularTitle:纵隔及腹腔恶性淋巴结的超声内镜声像图特征分析
- Author:
Yirui ZHANG
1
;
Jianwei ZHU
;
Duanmin HU
;
Lin YANG
;
Wei WU
;
Liming XU
;
Longjiang XU
;
Guilian CHENG
Author Information
1. 苏州大学附属第二医院消化科，苏州 215004
- Keywords:
Lymph nodes;
Malignant lymphadenopathy;
Mediastinal or abdominal;
Endoscopic ultrasonography;
Endoscopic ultrasonography-guided fine-needle aspiration
- From:
Chinese Journal of Digestive Endoscopy
2022;39(4):307-312
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the features of endoscopic ultrasonography in the diagnosis of malignant mediastinal and abdominal lymphadenopathy and to provide more evidence for endoscopic ultrasound-guided fine-needle aspiraiton (EUS-FNA).Methods:A case-control study was performed on 83 consecutive patients who underwent EUS in the Second Affiliated Hospital of Soochow University from September 2016 to February 2021. Lymph node properties were identified by pathological results of EUS-FNA and (or) surgery and follow-up for at least 6 months. According to the final diagnosis, patients were divided into malignant lymph node group ( n=56) and benign lymph node group ( n=27). Univariate analysis and multivariate logistic analysis were performed to identify independent risk factors for malignant lymphadenopathy in terms of EUS features. Results:Univariate analysis showed that the length of short axis, short-long axis ratio, shape, border, presence or absence of hilum, heterogeneous echo, and the growth pattern of lymph node were risk factors for malignant lymph nodes ( P<0.10). Multivariate logistic regression analysis showed that short axis>10 mm ( P=0.021, OR=9.751, 95% CI: 1.407-57.573), clear border ( P=0.009, OR=20.587, 95% CI: 2.149-197.251), absence of hilum ( P=0.019, OR=28.502, 95% CI: 1.725-470.864), nodal matting ( P=0.004, OR=45.539, 95% CI: 3.429-604.822), partial nodal fusion ( P=0.004, OR=50.012, 95% CI: 3.497-715.266) were independent risk factors for malignant mediastinal and abdominal lymph nodes. Conclusion:EUS is useful to differentiate the lymph node properties in the mediastinal or abdominal cavity. Short axis>10 mm, clear border, absence of hilum, nodal matting and partial nodal fusion are high-risk EUS features of malignant mediastinal or abdominal lymphadenopathy, where priority should be given to EUS-FNA.
