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      경부 림프절 절제 생검의 진단 정확도 분석 = Diagnostic Accuracy for Malignancy in Open Surgical Biopsy of Neck Lymph Nodes

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      https://www.riss.kr/link?id=A101612447

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      다국어 초록 (Multilingual Abstract)

      Background and Objectives The open surgical biopsy (OSB) of neck lymph nodes is considered a definite diagnostic procedure; however, the diagnostic accuracy of this procedure has not been fully studied. Thus, we aimed to identify the false negative rates of OSB for malignancy and the possible causes of misdiagnosis that might severely affect patient prognosis.
      Subjects and Method We extracted the data from 495 OSB of neck lymph nodes between 2005 and 2012. The diagnostic accuracy of OSB of neck lymph nodes was estimated based on re-biopsy. In addition, we reviewed possible clinical factors related to false negativity, cause of misdiagnosis and its clinical impacts.
      Results The false negative rate of OSB of neck nodes was 2.2% with a risk of 3.8% false diagnosis among subjects with initial ‘benign’ results. The cases of the initial misdiagnosis (n=7) had the dismal outcomes (4 deaths, 1 disease progression). The main cause of misdiagnosis was the failure to target the disease-affected lymph nodes (85.7%). Malignancy-related symptoms persisted in all cases of misdiagnosis, which required re-biopsy.
      Conclusion Accurate targeting of lymph nodes, close monitoring of clinical symptoms and comparison of biopsy results with symptoms are very important to reduce false negativity for malignancy in OSB of neck lymph nodes.
      Korean J Otorhinolaryngol-Head Neck Surg 2014;57(12):841-6
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      Background and Objectives The open surgical biopsy (OSB) of neck lymph nodes is considered a definite diagnostic procedure; however, the diagnostic accuracy of this procedure has not been fully studied. Thus, we aimed to identify the false negative ra...

      Background and Objectives The open surgical biopsy (OSB) of neck lymph nodes is considered a definite diagnostic procedure; however, the diagnostic accuracy of this procedure has not been fully studied. Thus, we aimed to identify the false negative rates of OSB for malignancy and the possible causes of misdiagnosis that might severely affect patient prognosis.
      Subjects and Method We extracted the data from 495 OSB of neck lymph nodes between 2005 and 2012. The diagnostic accuracy of OSB of neck lymph nodes was estimated based on re-biopsy. In addition, we reviewed possible clinical factors related to false negativity, cause of misdiagnosis and its clinical impacts.
      Results The false negative rate of OSB of neck nodes was 2.2% with a risk of 3.8% false diagnosis among subjects with initial ‘benign’ results. The cases of the initial misdiagnosis (n=7) had the dismal outcomes (4 deaths, 1 disease progression). The main cause of misdiagnosis was the failure to target the disease-affected lymph nodes (85.7%). Malignancy-related symptoms persisted in all cases of misdiagnosis, which required re-biopsy.
      Conclusion Accurate targeting of lymph nodes, close monitoring of clinical symptoms and comparison of biopsy results with symptoms are very important to reduce false negativity for malignancy in OSB of neck lymph nodes.
      Korean J Otorhinolaryngol-Head Neck Surg 2014;57(12):841-6

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      참고문헌 (Reference)

      1 Novoa E, "Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature" 34 (34): 1497-1503, 2012

      2 Picardi M, "Randomized comparison of power Doppler ultrasound-directed excisional biopsy with standard excisional biopsy for the characterization of lymphadenopathies in patients with suspected lymphoma" 22 (22): 3733-3740, 2004

      3 Balikci HH, "Neck masses: diagnostic analysis of 630 cases in Turkish population" 270 (270): 2953-2958, 2013

      4 Mrówka-Kata K, "Kikuchi-Fujimoto and Kimura diseases: the selected, rare causes of neck lymphadenopathy" 267 (267): 5-11, 2010

      5 Jeong WJ, "Initial work-up for cervical lymphadenopathy: back to basics" 269 (269): 2255-2263, 2012

      6 Yang J, "Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations" 111 (111): 306-315, 2007

      7 Baier ND, "Fine-needle aspiration biopsy of thyroid nodules: experience in a cohort of 944 patients" 193 (193): 1175-1179, 2009

      8 Schwarz R, "Fine needle aspiration cytology in the evaluation of head and neck masses" 159 (159): 482-485, 1990

      9 Aysegul Oz, "Efficiency of Ultrasound and Ultrasound-Guided Fine Needle Aspiration Cytology in Preoperative Assessment of Axillary Lymph Node Metastases in Breast Cancer" 한국유방암학회 15 (15): 211-217, 2012

      10 Chiu-Lung Chan R, "Effect of previous radiotherapy on cervical lymph node fine-needle aspiration cytology diagnostic accuracy in head and neck cancers" 122 (122): 1779-1781, 2012

      1 Novoa E, "Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature" 34 (34): 1497-1503, 2012

      2 Picardi M, "Randomized comparison of power Doppler ultrasound-directed excisional biopsy with standard excisional biopsy for the characterization of lymphadenopathies in patients with suspected lymphoma" 22 (22): 3733-3740, 2004

      3 Balikci HH, "Neck masses: diagnostic analysis of 630 cases in Turkish population" 270 (270): 2953-2958, 2013

      4 Mrówka-Kata K, "Kikuchi-Fujimoto and Kimura diseases: the selected, rare causes of neck lymphadenopathy" 267 (267): 5-11, 2010

      5 Jeong WJ, "Initial work-up for cervical lymphadenopathy: back to basics" 269 (269): 2255-2263, 2012

      6 Yang J, "Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations" 111 (111): 306-315, 2007

      7 Baier ND, "Fine-needle aspiration biopsy of thyroid nodules: experience in a cohort of 944 patients" 193 (193): 1175-1179, 2009

      8 Schwarz R, "Fine needle aspiration cytology in the evaluation of head and neck masses" 159 (159): 482-485, 1990

      9 Aysegul Oz, "Efficiency of Ultrasound and Ultrasound-Guided Fine Needle Aspiration Cytology in Preoperative Assessment of Axillary Lymph Node Metastases in Breast Cancer" 한국유방암학회 15 (15): 211-217, 2012

      10 Chiu-Lung Chan R, "Effect of previous radiotherapy on cervical lymph node fine-needle aspiration cytology diagnostic accuracy in head and neck cancers" 122 (122): 1779-1781, 2012

      11 Song JY, "Disease spectrum of cervical lymphadenitis: analysis based on ultrasound-guided core-needle gun biopsy" 55 (55): 310-316, 2007

      12 Amador-Ortiz C, "Combined core needle biopsy and fine-needle aspiration with ancillary studies correlate highly with traditional techniques in the diagnosis of nodal-based lymphoma" 135 (135): 516-524, 2011

      13 Iguchi H, "Clinical analysis of 21 cases of cervical tuberculous lymphadenitis without active pulmonary lesion" 133 (133): 977-983, 2013

      14 Atula TS, "Assessment of cervical lymph node status in head and neck cancer patients:palpation, computed tomography and low field magnetic resonance imaging compared with ultrasound-guided fine-needle aspiration cytology" 25 (25): 152-161, 1997

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