The Clinical Value of New Scoring System of Cervical Lymph Node

: 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.