The outcomes and decision-making process for neck lymph nodes with indeterminate fine-needle aspiration cytology
This study aims to propose a cytological classification, to evaluate predictive factors of the final malignancy, and to suggest a proper management strategy for neck lymph nodes (LNs) with indeterminate cytology. Patients who had neck lymphadenopathy with indeterminate cytology between 2007 and 2017...
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description | This study aims to propose a cytological classification, to evaluate predictive factors of the final malignancy, and to suggest a proper management strategy for neck lymph nodes (LNs) with indeterminate cytology.
Patients who had neck lymphadenopathy with indeterminate cytology between 2007 and 2017 were analyzed retrospectively in a tertiary medical center. Cytological classification was conducted according to the cytological descriptions. We examined the clinical characteristics according to the final diagnosis of the neck lymphadenopathy.
According to the final diagnoses, there were 142 malignant and 95 benign neck LNs among 237 patients. Multivariate analyses using a stepwise logistic regression model showed that cytological classification [p < 0.001, OR = 5.67 (3.48-9.23)], prior history of malignancy [p = 0.01, OR = 2.97 (1.26-6.99)], long axis [p = 0.01, OR = 3.06 (1.33-7.06)], short-to-long axis (S/L) ratio [p = 0.047, OR = 2.15 (1.01-4.57)] and internal echogenicity [p = 0.01, OR = 2.72 (1.26-5.86)] were independent predictors of malignancy.
In patients who have neck LNs with indeterminate cytology, a cytological classification and four other predictors (prior history of malignancy, long axis ≥ 1.93 cm, S/L ratio ≥ 0.64 and heterogeneity of internal echogenicity) are statistically associated with the risk of malignancy and helpful in guiding further management. |
doi_str_mv | 10.1371/journal.pone.0246437 |
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Patients who had neck lymphadenopathy with indeterminate cytology between 2007 and 2017 were analyzed retrospectively in a tertiary medical center. Cytological classification was conducted according to the cytological descriptions. We examined the clinical characteristics according to the final diagnosis of the neck lymphadenopathy.
According to the final diagnoses, there were 142 malignant and 95 benign neck LNs among 237 patients. Multivariate analyses using a stepwise logistic regression model showed that cytological classification [p < 0.001, OR = 5.67 (3.48-9.23)], prior history of malignancy [p = 0.01, OR = 2.97 (1.26-6.99)], long axis [p = 0.01, OR = 3.06 (1.33-7.06)], short-to-long axis (S/L) ratio [p = 0.047, OR = 2.15 (1.01-4.57)] and internal echogenicity [p = 0.01, OR = 2.72 (1.26-5.86)] were independent predictors of malignancy.
In patients who have neck LNs with indeterminate cytology, a cytological classification and four other predictors (prior history of malignancy, long axis ≥ 1.93 cm, S/L ratio ≥ 0.64 and heterogeneity of internal echogenicity) are statistically associated with the risk of malignancy and helpful in guiding further management.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0246437</identifier><identifier>PMID: 33539457</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Biology and Life Sciences ; Biomedical engineering ; Biopsy ; Biopsy, Needle ; Cellular biology ; Cytology ; Decision making ; Diagnosis ; Drafting software ; Editing ; Electrical engineering ; Electronic mail ; Head and neck ; Lymph nodes ; Lymphadenopathy ; Lymphoma ; Medical diagnosis ; Medical examination ; Medicine and Health Sciences ; Methodology ; Methods ; Multivariate analysis ; Neck ; Otolaryngology ; Patients ; Regression analysis ; Regression models ; Risk analysis ; Risk factors ; Risk groups ; Software ; Statistical analysis ; Surgery ; Thyroid gland ; Visualization</subject><ispartof>PloS one, 2021-02, Vol.16 (2), p.e0246437-e0246437</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Cheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Cheng et al 2021 Cheng et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c641t-b7ba5ccd3af153312002e564904f2ef40b38c3efb5eaed9efc910699f6c7be9a3</cites><orcidid>0000-0003-2772-0983</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861456/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861456/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33539457$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Moore, Francis</contributor><creatorcontrib>Cheng, Ping-Chia</creatorcontrib><creatorcontrib>Chang, Chih-Ming</creatorcontrib><creatorcontrib>Liao, Li-Jen</creatorcontrib><creatorcontrib>Cheng, Po-Wen</creatorcontrib><creatorcontrib>Lo, Wu-Chia</creatorcontrib><title>The outcomes and decision-making process for neck lymph nodes with indeterminate fine-needle aspiration cytology</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>This study aims to propose a cytological classification, to evaluate predictive factors of the final malignancy, and to suggest a proper management strategy for neck lymph nodes (LNs) with indeterminate cytology.
Patients who had neck lymphadenopathy with indeterminate cytology between 2007 and 2017 were analyzed retrospectively in a tertiary medical center. Cytological classification was conducted according to the cytological descriptions. We examined the clinical characteristics according to the final diagnosis of the neck lymphadenopathy.
According to the final diagnoses, there were 142 malignant and 95 benign neck LNs among 237 patients. Multivariate analyses using a stepwise logistic regression model showed that cytological classification [p < 0.001, OR = 5.67 (3.48-9.23)], prior history of malignancy [p = 0.01, OR = 2.97 (1.26-6.99)], long axis [p = 0.01, OR = 3.06 (1.33-7.06)], short-to-long axis (S/L) ratio [p = 0.047, OR = 2.15 (1.01-4.57)] and internal echogenicity [p = 0.01, OR = 2.72 (1.26-5.86)] were independent predictors of malignancy.
In patients who have neck LNs with indeterminate cytology, a cytological classification and four other predictors (prior history of malignancy, long axis ≥ 1.93 cm, S/L ratio ≥ 0.64 and heterogeneity of internal echogenicity) are statistically associated with the risk of malignancy and helpful in guiding further management.</description><subject>Age</subject><subject>Biology and Life Sciences</subject><subject>Biomedical engineering</subject><subject>Biopsy</subject><subject>Biopsy, Needle</subject><subject>Cellular biology</subject><subject>Cytology</subject><subject>Decision making</subject><subject>Diagnosis</subject><subject>Drafting software</subject><subject>Editing</subject><subject>Electrical engineering</subject><subject>Electronic mail</subject><subject>Head and neck</subject><subject>Lymph nodes</subject><subject>Lymphadenopathy</subject><subject>Lymphoma</subject><subject>Medical diagnosis</subject><subject>Medical examination</subject><subject>Medicine and Health 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outcomes and decision-making process for neck lymph nodes with indeterminate fine-needle aspiration cytology</title><author>Cheng, Ping-Chia ; Chang, Chih-Ming ; Liao, Li-Jen ; Cheng, Po-Wen ; Lo, Wu-Chia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c641t-b7ba5ccd3af153312002e564904f2ef40b38c3efb5eaed9efc910699f6c7be9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Biology and Life Sciences</topic><topic>Biomedical engineering</topic><topic>Biopsy</topic><topic>Biopsy, Needle</topic><topic>Cellular biology</topic><topic>Cytology</topic><topic>Decision making</topic><topic>Diagnosis</topic><topic>Drafting software</topic><topic>Editing</topic><topic>Electrical engineering</topic><topic>Electronic mail</topic><topic>Head and neck</topic><topic>Lymph nodes</topic><topic>Lymphadenopathy</topic><topic>Lymphoma</topic><topic>Medical diagnosis</topic><topic>Medical examination</topic><topic>Medicine and Health Sciences</topic><topic>Methodology</topic><topic>Methods</topic><topic>Multivariate analysis</topic><topic>Neck</topic><topic>Otolaryngology</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Risk groups</topic><topic>Software</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Thyroid gland</topic><topic>Visualization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, Ping-Chia</creatorcontrib><creatorcontrib>Chang, Chih-Ming</creatorcontrib><creatorcontrib>Liao, Li-Jen</creatorcontrib><creatorcontrib>Cheng, Po-Wen</creatorcontrib><creatorcontrib>Lo, Wu-Chia</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: 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Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, Ping-Chia</au><au>Chang, Chih-Ming</au><au>Liao, Li-Jen</au><au>Cheng, Po-Wen</au><au>Lo, Wu-Chia</au><au>Moore, Francis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The outcomes and decision-making process for neck lymph nodes with indeterminate fine-needle aspiration cytology</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-02-04</date><risdate>2021</risdate><volume>16</volume><issue>2</issue><spage>e0246437</spage><epage>e0246437</epage><pages>e0246437-e0246437</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>This study aims to propose a cytological classification, to evaluate predictive factors of the final malignancy, and to suggest a proper management strategy for neck lymph nodes (LNs) with indeterminate cytology.
Patients who had neck lymphadenopathy with indeterminate cytology between 2007 and 2017 were analyzed retrospectively in a tertiary medical center. Cytological classification was conducted according to the cytological descriptions. We examined the clinical characteristics according to the final diagnosis of the neck lymphadenopathy.
According to the final diagnoses, there were 142 malignant and 95 benign neck LNs among 237 patients. Multivariate analyses using a stepwise logistic regression model showed that cytological classification [p < 0.001, OR = 5.67 (3.48-9.23)], prior history of malignancy [p = 0.01, OR = 2.97 (1.26-6.99)], long axis [p = 0.01, OR = 3.06 (1.33-7.06)], short-to-long axis (S/L) ratio [p = 0.047, OR = 2.15 (1.01-4.57)] and internal echogenicity [p = 0.01, OR = 2.72 (1.26-5.86)] were independent predictors of malignancy.
In patients who have neck LNs with indeterminate cytology, a cytological classification and four other predictors (prior history of malignancy, long axis ≥ 1.93 cm, S/L ratio ≥ 0.64 and heterogeneity of internal echogenicity) are statistically associated with the risk of malignancy and helpful in guiding further management.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33539457</pmid><doi>10.1371/journal.pone.0246437</doi><tpages>e0246437</tpages><orcidid>https://orcid.org/0000-0003-2772-0983</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Age Biology and Life Sciences Biomedical engineering Biopsy Biopsy, Needle Cellular biology Cytology Decision making Diagnosis Drafting software Editing Electrical engineering Electronic mail Head and neck Lymph nodes Lymphadenopathy Lymphoma Medical diagnosis Medical examination Medicine and Health Sciences Methodology Methods Multivariate analysis Neck Otolaryngology Patients Regression analysis Regression models Risk analysis Risk factors Risk groups Software Statistical analysis Surgery Thyroid gland Visualization |
title | The outcomes and decision-making process for neck lymph nodes with indeterminate fine-needle aspiration cytology |
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