目的:颈部是各种病因的孤立性囊性颈肿块(SCNM)的常见部位,包括先天性的,炎症,和肿瘤。在成年人中,主要病灶是排除恶性肿瘤.这项研究的目的是回顾性分析可用的诊断技术在成年患者中鉴别良恶性SCNM的准确性。该研究旨在开发新的临床实践指南,以评估和管理SCNM。
方法:主要预测变量是细针穿刺细胞学(FNAC)的诊断效用,超声(U/S),多层计算机断层扫描,和磁共振成像。研究的终点是区分良性和恶性SCNM的总体诊断准确性。最终诊断基于组织病理学。
结果:该研究包括79例成年患者:男性55例(69.62%),女性24例(30.38%)(P<0.05)。演示时的平均年龄为42.1岁(范围:18-84岁)。孤立性囊性颈肿块分布在颈前区30例(37.97%),颈后外侧区49例(62.03%)(P<0.05)。颈后外侧区的恶性SCNM发生率明显高于颈前区[19/49(38.78%)对1/30(3.33%)](P<0.05)。U/S+FNAC与U/S+FNAC+多层螺旋CT和/或磁共振成像组在良恶性SCNM鉴别方面差异无统计学意义(40/42对36/37,P>0.05)。2例记录“侵犯颈部”。
结论:应采用系统的调查方案来评估成年SCNM患者。
OBJECTIVE: The neck region is a common site for solitary cystic neck mass (SCNM) of various etiologies, including congenital, inflammatory, and neoplastic. In adults, the primary focus is excluding malignancy. The objective of this study was to retrospectively analyze the accuracy of available diagnostic technologies for the differentiation of benign and malignant SCNM in adult patients. The study aimed to develop new clinical practice
guidelines for evaluating and managing SCNM.
METHODS: The primary predictive variables were the diagnostic utilities of fine-needle aspiration cytology (FNAC), ultrasound (U/S), multislice computed tomography, and magnetic resonance imaging. The study\'s endpoint was the overall diagnostic accuracy in differentiating between benign and malignant SCNM. The final diagnosis was based on histopathology.
RESULTS: The study included 79 adult patients: 55 (69.62%) male and 24 (30.38%) female ( P <0.05). The mean age at presentation was 42.1 years (range: 18-84 years). Solitary cystic neck mass was distributed in the anterior neck region in 30 (37.97%) patients and the posterolateral neck regions in 49 (62.03%) patients ( P <0.05). The posterolateral neck regions had a significantly higher rate of malignant SCNM than the anterior neck region [19/49 (38.78%) versus 1/30 (3.33%)] ( P <0.05). There was no statistically significant difference between the U/S+FNAC and U/S+FNAC+multislice computed tomography and/or magnetic resonance imaging groups in differentiating benign and malignant SCNM (40/42 versus 36/37, P >0.05). \"Violated neck\" was recorded in 2 cases.
CONCLUSIONS: A systematic investigation protocol should be applied to evaluate adult patients with SCNM.