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The Clinical Value of New Scoring System of Cervical Lymph Node

Shen, Haolin PhD*; Lv, Guorong MD; Ke, Linfang MD*; Li, Ling MD*; Zheng, Chunnuan BS; Yang, Shuping BS*

doi: 10.1097/RUQ.0000000000000427
Original Research

To distinguish malignant cervical lymphadenopathy, we established a new scoring system based on ultrasound features. Two hundred sixty-three patients with cervical lymphadenopathy received ultrasonic examination and underwent ultrasound-guided core needle biopsy or fine needle aspiration. The scoring system was proposed by multivariate logistic regression analysis and compared with Liao scoring system (0.06 × age + 4.76 × shortest-to-longest axis ratio + 2.15 × internal echo + 1.80 × vascular pattern). A new scoring system model, 1.346 × margin + 1.339 × hilum + 2.411 × calcification + 2.619 × vascular pattern + 0.837 × shortest-to-longest axis ratio, was generated. Lymph nodes were regarded as malignancy when the score was ≥2.4. Compared with the Liao scoring system, the new scoring system had larger area under the curve (0.86 versus 0.76, P = 0.036), specificity (86.7% versus 75.0%, P = 0.001), accuracy (87.1% versus 80.6%, P = 0.007), and positive predictive value (89.0% versus 80.0%, P = 0.043). Sensitivity (87.4% versus 85.3%, P = 0.647) and negative predictive value (85.0% versus 81.0%, P = 0.395) did not differ. We concluded that the new scoring system is more reliable and can play an important role in the differential diagnosis of cervical lymph nodes.

*Department of Ultrasound, Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou

Department of Clinical Medicine, Quanzhou Medical College, Quanzhou

Department of Pathology, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, Fujian, China.

Received for publication September 28, 2018; accepted December 12, 2018.

Address correspondence to: Shuping Yang, BS, Department of Ultrasound, Zhangzhou Hospital affiliated to Fujian Medical University, No. 59 North Shengli Rd, Zhangzhou 363000, Fujian, China (e-mail:

This study was supported by Fujian Technological Innovation Joint Subject (2017Y9071).

The authors declare no conflict of interest.

Online date: February 5, 2019

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