A paired comparative analysis of ultrasound-guided fine-needle aspiration and core-needle biopsy in malignant lymph nodes: Implications for clinical practice
Qinxian Zhao, Zhonghua Yue, Fengyi Yu, Fengxia Hu, Huihui Niu, Hui Wang, Xincun Zhang, Zhen WangABSTRACT
Purpose:
This study aimed to compare the diagnostic sensitivity of ultrasound-guided fine-needle aspiration biopsy (FNAB), core-needle biopsy (CNB), and their combination in malignant superficial lymph nodes while identifying key influencing factors.
Materials and Methods:
A total of 390 patients with malignant superficial lymph nodes undergoing simultaneous FNAB and CNB were included in this retrospective study. Sensitivity and false-negative rates were calculated for each method. McNemar’s test was used for pairwise comparisons, and factors associated with false-negative results were analyzed via logistic regression.
Results:
The overall sensitivity reached 89.23% for FNAB, 96.92% for CNB, and 97.44% for the combined approach. In particular, CNB showed significantly higher sensitivity than FNAB, especially in lymphoma (100% versus 51.52%) and lymph nodes >3 cm (98.46% versus 86.15%). By contrast, the combined strategy showed only a marginal increase in sensitivity (+0.52%). McNemar’s test revealed 32 FNAB false negatives versus two CNB false negatives (
Conclusion:
CNB exhibits superior sensitivity over FNAB for malignant lymphadenopathy. On the contrary, the combined approach adds minimal benefit (+0.52%), and it is not justified for routine use. Thus, CNB should be the preferred first-line biopsy method.