title: [The predictive value of gray scale sonographic features in malignant hilar and mediastinal lymph node].
abstract: OBJECTIVE
  To explore the sonographic features of malignant hilar and mediastinal lymph nodes and the predictive value.
  
  
  METHODS
  We performed retrospective analysis of 390 lymph nodes under the endobronchial ultrasound-guided transbronchial needle aspiration for diagnosis in the bronchoscope center of the First Affiliated Hospital of Guangzhou Medical University from November 1st, 2012 to November 31st, 2013. They were divided into malignant and benign groups, and sonographic features of lymph nodes were analyzed, including the length of short axis, shape, margin, echogenicity, homogenicity, coagulation necrosis, calcification, coalesence and posterior acoustic enhancement.
  
  
  RESULTS
  A total of 390 lymph nodes were evaluated, including 207 malignant and 183 benign lymph nodes, respectively. The accuracy based on the length of short axis, shape, margin, echogenicity, homogenicity, coagulation necrosis, calcification, coalesence and posterior acoustic enhancement to predict the malignancy were 61.0% (238/390), 75.4% (294/390), 75.6% (295/390), 73.8% (288/390), 65.9% (257/390), 68.2% (266/390), 51.8% (202/390), 55.1% (215/390), 67.4% (263/390), respectively. Binary multivariable logistic regression analysis revealed that 5 parameters, including round, distinct margin and heterogeneous, hypoechoic, and posterior acoustic enhancement possessed a significant predictive value(P < 0.05).We found that only 35.3% (73/207) malignant lymph nodes possessed these 5 ultrasonographic characteristics, and the diagnosis rate was 93.6% (73/78).72.46% (150/207) malignant lymph nodes possessed any 4 or more positive sonographic features, and the diagnosis rate was 85.2% (150/176).85.0% (176/207) malignant lymph nodes had any 3 or more positive sonographic features, and the diagnosis rate was 84.6% (176/208).
  
  
  CONCLUSIONS
  The combination of gray scale sonographic features has a predictive value in the diagnosis of malignant hilar and mediastinal lymph nodes.
authors.affiliation: State Key Lab of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Weizhan
authors.initials: W
authors.lastname: Luo
authors.affiliation: State Key Lab of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Changhao
authors.initials: C
authors.lastname: Zhong
authors.affiliation: State Key Lab of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: State Key Lab of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Chen
authors.affiliation: State Key Lab of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Yunxiang
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: State Key Lab of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China. Email: lishiyue@188. com.
authors.forename: Shiyue
authors.initials: S
authors.lastname: Li
mesh_terms: D044963:Biopsy, Fine-Needle; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional