Diagnostic Accuracy of Ultrasononography in Detection for Diagnosis of Malignancy of Lymph Nodes in Newly Diagnosed Head and Neck Carcinoma Patients Taking Histopathology as Gold Standard
AbstractTo determine the diagnostic accuracy of ultrasonography for diagnosis of malignancy of lymph node in newly diagnosed head and neck carcinomas patients, taking histopathology as gold standard.
MethodsThis cross-sectional study was undertaken in Department of Radiology, Jinnah Hospital, Lahore. Total 168 newly diagnosed cases with head and neck carcinoma, 20-80 years of age of both genders were selected. All the patients with history of previous neck surgery, on chemotherapy or any other oncology treatment and recurrent cases were excluded. After taking informed consent, ultrasonography of neck was performed. Each USG findings were interpreted by one consultant radiologist and were looked for malignant lymph nodes as per-operational definition. USG findings were compared with histopathology findings.
Results Age range in this study was from 20-80 years with mean age of 50.33 ± 11.98 years. Majority of the patients 92 (54.76%) were between 20-50 years of age. Out of these 168 patients, 98 (58.33%) were males and 70 (41.67%) were females with ratio of 1.4:1. All the patients were subjected to USG and found that 83 were True Positive and 08 were False Positive. Among 77, USG negative patients, 07 (False Negative) had malignant lymph nodes on histopathology whereas 70 (True Negative) had benign lymph nodes on histopathology (p=0.0001). Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasonography for diagnosis of malignancy of lymph node in newly diagnosed head and neck carcinomas patients was 92.22%, 89.74%, 91.21%, 90.91% and 91.07% respectively.
Conclusion This study concluded that ultrasound is a highly sensitive and accurate non-invasive modality for detecting malignant lymph node in head and neck cancers.
Keywords:head and neck cancers, lymph node metastasis, ultrasound.
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