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. 2022 Feb 7;12(1):2048.
doi: 10.1038/s41598-022-06102-0.

Diagnostic performance of core needle biopsy for nodal recurrences in patients with head and neck squamous cell carcinoma

Ta-Hsuan Lo  1   2 , Cheng-Ping Wang  1 , Chun-Nan Chen  1 , Tsung-Lin Yang  1 , Pei-Jen Lou  1 , Jenq-Yuh Ko  1 , Yih-Leong Chang  3   4 , Tseng-Cheng Chen  5
Affiliations

Diagnostic performance of core needle biopsy for nodal recurrences in patients with head and neck squamous cell carcinoma

Ta-Hsuan Lo et al. Sci Rep. .

Abstract

This study investigated the diagnostic accuracy and affecting factors of ultrasound (US)-guided core-needle biopsy (CNB) in patients with treated head and neck squamous cell carcinoma (HNSCC). We retrospectively reviewed patients with treated HNSCC who received US-guided CNB from January 2011 to December 2018 with corresponding imaging. Pathological necrosis and fibrosis of targeted lymph nodes (LNs) were evaluated. We analyzed the correlation between CNB accuracy and clinical and pathological characteristics. In total, 260 patients were included. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CNB for nodal recurrence were 84.47%, 100%, 100%, 54.67%, and 86.92%, respectively. CNB of fibrotic LNs had significantly worse sensitivity, NPV, and accuracy than that of non-fibrotic LNs. Similarly, CNB of necrotic LNs had significantly worse sensitivity, NPV, and accuracy than non-necrotic LNs. Multivariate regression revealed that fibrotic LN was the only independent factor for a true positive rate, whereas both necrotic LN and fibrotic LN were independent factors for a false negative rate. The diagnostic accuracy of CNB in treated HNSCC patients is affected by LN necrosis and fibrosis. Therefore, CNB results, particularly for necrotic or fibrotic LNs, should be interpreted carefully.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The sensitivity, negative predictive value, and accuracy of (A) core-needle biopsy (CNB) in patients with treated head and neck squamous cell carcinoma, overall; (B) CNB for the lymph node (LN) with and without fibrotic LN; and (C) CNB for the LN with and without necrotic LN.
Figure 2
Figure 2
Forest plot of multivariate analysis of possible impacting factors using the logistic regression method in (A) true positive rates and (B) false negative rates.
Figure 3
Figure 3
(A) Ultrasound image of the treated left tongue cancer with an ipsilateral level IV nodal mass; (B) corresponding magnetic resonance imaging showing necrotic changes with a T2 axial view; (C) core-needle biopsy (CNB) revealed necrotic tissue with metastatic squamous cell carcinoma (SCC) in nests infiltrated in the fibrotic stroma; and (D) tissue from salvage neck dissection revealed metastatic SCC without extranodal extension.
Figure 4
Figure 4
(A) Ultrasound picture of treated right tongue cancer with ipsilateral nodal mass; (B) corresponding magnetic resonance imaging showing axial view of T1 with gadolinium contrast medium; (C) core-needle biopsy revealed fibrotic tissue only; (D) Open biopsy revealed fibrotic tissue with metastatic squamous cell carcinoma and focal extracellular keratin deposition.
See this image and copyright information in PMC

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