Application Value Of Superficial Lymph Node Biopsy Guided By Ultrasound In Children

Objective: The study is designed to evaluate the clinical value of ultrasound-guided superficial lymph node biopsy in children with lymphadenopathy.Methods: We collected the results of ultrasound-guided lymph node biopsy in children under 12 years old with superficial lymphadenopathy in the Affiliated Hospital of Qingdao University from August 2013 to August 2019,and made a retrospective analysis.195 children with complete data were studied synthetically according to their clinical characteristics and postoperative pathology.Results: 1.Preoperative data: There were 123 males and 72 females,with a sex ratio of 1.7:1 among the 195 child patients.The youngest was 8 months old and the oldest was 12 years old,with an average of 8.4 years old.The distribution of lymph nodes: 6 cases under jaw,1 case in bilateral neck,87 cases in right neck,98 cases in left neck and 4 cases in armpit.The final clinical diagnosis included 173 benign cases and 22 malignant cases.2.Pathological diagnosis: Among 195 children,166 cases of benign diagnosis were made by needle biopsy,including 63 cases of lymph node hyperplasia,7 cases of lymph node tuberculosis,94 cases of tissue necrotic lymphadenitis,and 2 cases of suppurative lymphadenitis.One case of lymph node tuberculosis was misdiagnosed,and the final diagnosis was lymphadenitis.21 cases of malignant diagnosis included 12 cases of lymphoma,8 cases of metastatic carcinoma,1 case of Langerhans cell histiocytosis.8 cases had no diagnosis.The final clinical diagnosis Includes 1 case of Hodgkin’s lymphoma(confirmed by surgical biopsy),5 cases of lymphadenitis,and 2 cases of necrotizing lymphadenitis.3.Diagnostic sensitivity and specificity: Ultrasound-guided biopsy in children with superficial lymph node malignancy: sensitivity is 95.5%,specificity is 100%.The positive predictive value was 100% and the negative predictive value was 99.4%.4.The clinical diagnostic accuracy of the patients: 186 of 195 patients were diagnosed correctly by ultrasound-guided lymph node biopsy,and the diagnostic accuracy was 95.4%.The accuracy of acupuncture pathological diagnosis was 99.4%(161/162)when the material was satisfactory,and the diagnostic accuracy was 75.8%(25/33)when the material was not satisfied.The difference was statistically significant.The satisfaction of the materials and the diagnostic accuracy were obtained.Positive correlation(χ2=29.59,P<0.05).The correct rate of immunohistochemical pathology was 99.0%(99/100),and the correct rate of immunohistochemical pathology was 91.6%(87/95).The difference was statistically significant(χ2=4.52,P< 0.05).5.The levels and nature of cervical lymph node lesions: The level II is most involved in malignant cases,accounting for 72.7%(8/11).The level II is also most involved in benign cases,accounting for 81.6%(71/87),followed by level III,accounting for 67.8%(59/87).Histiocytic necrotizing lymphadenitis was evenly distributed in level II to V.6.Relationship with superficial lymph node characteristics: There were statistically significant differences in lymph node size(χ2 = 8.8942,P = 0.0029)and activity(χ2 = 12.5261,P = 0.0004).The difference in lymph node activity was the most significant.7.Safety: All the child patients didn’t develop major bleeding or other serious complications.Conclusion: 1.The sensitivity and specificity of ultrasound-guided superficial lymph node biopsy were 95.5% and 100% respectively.The positive predictive value is 100% and the negative predictive value is 99.4%,so it can be used as one of the important methods for accurate diagnosis of children’s malignant tumors.2.Ultrasound-guided superficial lymph node biopsy had high specificity and sensitivity,which with the characteristics of easy and safe in operation,low in cost and good tolerance in children.Ultrasound-guided superficial lymph node biopsy had broad application prospects.