A probability prediction rule for malignant cervical lymphadenopathy using sonography
Journal
Head and Neck
Journal Volume
22
Journal Issue
3
Pages
223-228
Date Issued
2000
Author(s)
Abstract
Background. Our purpose was to weigh various sonographic parameters as predicting malignant cervical lymphadenopathy and build a reliable prediction rule. Methods. One hundred and eighty-nine cervical lymph node lesions from 125 consecutive patients were used for building the prediction model. Sonographic variables, including 15 morphologic features of B-mode, 5 vascular parameters of color Doppler mode, along with age and sex, were analyzed with multivariate logistic regression to evaluate the joint effect of a set of independent variables. A prediction rule for malignant lymphadenopathy was established, and prospective validation was assessed on a new group consisting of 100 lymph nodes from another 60 consecutive patients. Results. The association of heterogeneous content, long transverse diameter, pathologic vascular pattern, high vascular density, and older age provided the most robust prediction value. Scoring scale was designed as 1x (age) + 2x (vascularity index) + 3x (short axis) + 4x (vascular pattern) + 4x (internal echo) according to the parameter estimates of multivariate logistic regression analysis. Cut-off value of score ?10 as malignancy resulted in 89.2% sensitivity and 85.2% specificity. Prospective validation also showed satisfactory results (sensitivity, 82.9%; specificity, 86.2%). Conclusions. By measuring only 4 sonographic parameters and age, this prediction rule could provide the physician a nonconfusing and reliable probability reference for managing cervical lymphadenopathy. (C) 2000 John Wiley and Sons, Inc.
SDGs
Other Subjects
adolescent; adult; aged; article; cervical lymph node; echography; female; human; lymphadenopathy; major clinical study; male; malignant neoplastic disease; prediction; priority journal; probability; scoring system; validation process; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Carcinoma; Female; Humans; Logistic Models; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Multivariate Analysis; Neck; Predictive Value of Tests; Prognosis; Sarcoma; Sensitivity and Specificity; Sex Factors; Ultrasonography, Doppler, Color
Type
journal article