Color Doppler Ultrasound In The Diagnosis And Therapy For Laryngeal Carcinoma With Metastasis Of Cervical Lymph Node

Objective:Through the examination of cervical lymph nodes for laryngeal carcinomawith metastasis by Color Doppler ultrasound，analysis the preoperativeexamination results of color Doppler ultrasound,CT and palpation according tothe post-operative pathological diagnosis， evaluate the Coincidence ratebetween the detection rate of laryngeal carcinoma with enlarged lymph nodesand laryngeal carcinoma with lymph node metastasis. Discuss the value ofColor Doppler ultrasound in clinical diagnosis and treatment of laryngealcarcinoma with cervical lymph node metastasis.Methods:We observed30patients (60) those accepted laryngectomy（partial、total）+neck dissection whose post-operative pathological diagnosis waslaryngeal squamous cell carcinomas with metastasis of cervical lymph nodein our department from December2009to October2011. All patients acceptedthe neck Color Doppler ultrasound examination and performed the surgeryreferring to the results of CT.we Comparative analysis the detection ratebetween pre-operative Color Doppler ultrasound and CT, pre-operative ColorDoppler ultrasound and neck palpation;the Coincidence rate betweenpre-operative Color Doppler ultrasound with CT and post-operativepathological diagnosis, pre-operative Color Doppler ultrasound with neckpalpation and post-operative pathological diagnosis;less than1.5cm andgreater than1.5cm metastasis of cervical lymph node in the post-operativepathological diagnosis for cervical lymph node with laryngeal carcinoma.Statistical tests performed by using McNemar chi-square test,Pearson chi-square test and Fisher accurate test. Results:1. The detection rate of the neck lymph nodes of patients with laryngealcancer by color Doppler ultrasound is81.67%, the detection rate by CT is68.33%.McNemar paired chi-square test, P values>0.05; The diagnosis rate ofthe neck lymph nodes of patients with laryngeal cancer by color Dopplerultrasound is97.14%,the diagnosis rate by CT is91.43%., Pearson chi-squaretest, P>0.05; The misdiagnosis rate of the neck lymph nodes of patients withlaryngeal cancer by color Doppler ultrasound is17.14%, the missed rate is2.86%， the misdiagnosis rate by CT is25.71%，the missed rate by CT is8.57%; There was no significant difference in the detection of laryngeal andneck lymph nodes or the performance diagnosis of laryngeal and neck lymphnode metastasis between Ultrasonography and CT.2. The detection rate of the neck lymph nodes of30patients with laryngealcancer by color Doppler ultrasound is81.67%,it was significantly higher thanthe detection rate of Palpation25.00%, McNemar paired chi-square test, Pvalues<0.05, there was significant difference;The diagnosis rate of the necklymph nodes of patients with laryngeal cancer by color Doppler ultrasound is97.14%, the rate of Palpation compliance is28.57%, Pearson chi-square test,P<0.05, there was significant difference.The application of color Dopplerultrasound can easily find cervical lymph node that palpation difficultly tofind,and the cervical lymph node that the Color Doppler ultrasound can easilyfind but the palpation failed to find were confirmed as lymph node metastasisThe detection of laryngeal with neck lymph nodes and the performancediagnosis of laryngeal and neck lymph node metastasis by Ultrasonography issignificantly superior to palpation.3. By the Fisher exact test, the transfer rate of Laryngeal with neck lymphnode metastasis less than1.5cm and greater than1.5cm have significant difference,P<0.05.If color Doppler ultrasound examination revealed morethan1.5cm cervical lymph node, the possibility of transferring is significantlyincreased.Conclusions:1.The sensitivity of the detection for laryngeal with neck lymph nodes and theperformance diagnosis for laryngeal and neck lymph node metastasis byUltrasonography is higher.2. The results of examination can provide evidences for cervical lymphnode surgery while reduce the trauma form over-treatment.In summary,theColor Doppler have great value in the clinical diagnosis and treatment oflaryngeal cancer with cervical lymph node metastasis.3. The metastasis of Laryngeal cancer lymph node is an important factorfor laryngeal cancer prognosis.The possibility of color Doppler ultrasoundexamination reveale the metastasis lymph node that greater than1.5cm isgreat,so we should give great attention.