Rapid access multidisciplinary lymph node diagnostic clinic: analysis of 550 patients
Autor: | S. A. Haque, Tracey Murray, Ian Chau, M. Allen, P.A. Trott, G. Querci della Rovere, L Bishop, Peter Rhys-Evans, A. Wotherspoon, M T Kelleher, Gina Brown, A. R. Norman, D D Cunningham, Justin S. Waters |
---|---|
Rok vydání: | 2003 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Referral diagnosis Malignancy Clinical lymphadenopathy Neoplasms Internal medicine Biopsy Humans Medicine fine-needle aspiration Oncology & Carcinogenesis Lymphatic Diseases Lymph node Science & Technology medicine.diagnostic_test ultrasound business.industry Biopsy Needle Middle Aged medicine.disease Confidence interval Surgery Fine-needle aspiration medicine.anatomical_structure Oncology Relative risk Female Lymph Nodes Lymph business Life Sciences & Biomedicine 1112 Oncology And Carcinogenesis malignancy |
Zdroj: | British Journal of Cancer |
ISSN: | 1532-1827 0007-0920 |
Popis: | Lymphadenopathy is common, affecting patients of all ages. The current referral pattern for investigating patients with lymphadenopathy varies widely with no universally practised pathway. Our institution set up a lymph node diagnostic clinic (LNDC) accepting direct referrals from primary care physicians. Details of clinical presentation and investigations were recorded prospectively. Between December 1996 and July 2001, 550 patients were referred (M: 203; F:347). The median age was 40 years (range 14-90). The median time between initial referral and the first clinic visit was 6 days. Of 95 patients diagnosed to have malignant diseases, the median time from the first clinic visit to reaching malignant diagnosis was 15 days. Multivariate logistic regression analysis identified five significant predictors for malignant nodes: male gender (risk ratio (RR)=2.72; 95% confidence interval (CI): 1.63-4.56), increasing age (RR=1.05; 95% CI: 1.04-1.07), white ethnicity (RR=3.01; 95% CI: 1.19-7.6) and sites of lymph nodes: supraclavicular region (RR=3.72; 95% CI: 1.52-9.12) andor = 2 regions of lymph nodes (RR=6.41; 95% CI: 2.82-14.58). Ultrasound and fine-needle aspiration cytology of palpable lymph nodes were performed in 154 and 289 patients, respectively. An accuracy of 97 and 84% was found, respectively. In conclusion, a multidisciplinary lymph node diagnostic clinic enables a rapid, concerted approach to a common medical problem and patients with malignant diseases were diagnosed in a timely fashion. |
Databáze: | OpenAIRE |
Externí odkaz: |