Core Needle Biopsy May Predict Prognosis Preoperatively in Parotid Cancer.

IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY
Jeong-Yeon Ji, Wonjae Cha, Young Ho Jung, Soon-Hyun Ahn, Woo-Jin Jeong
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引用次数: 0

Abstract

Objectives: Salivary gland tumors present a diagnostic challenge, with preoperative false-negative results frequently leading to an unexpected diagnosis of malignancy after parotidectomy. This study was conducted to explore the clinical utility of preoperative core needle biopsy (CNB) in diagnosing malignancies before primary parotidectomy and to assess the prognostic implications of CNB for parotid gland cancers.

Methods: This retrospective cohort study included 615 patients who underwent preoperative CNB and parotidectomy for primary parotid tumors from 2003 to 2023 at a tertiary referral hospital. Among these patients, 102 who were diagnosed with primary parotid malignancy following parotidectomy were examined regarding survival outcomes. Disease-free survival (DFS) and predictive factors were assessed through univariable and multivariable analyses. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CNB were determined. These metrics were then compared to those of a separate cohort of 547 patients who underwent ultrasound-guided fine needle aspiration (FNA) and parotidectomy within the same timeframe.

Results: In the CNB group, the 5-year predicted DFS was 86.9% (95% CI, 79.2%-95.3%). Multivariable analysis identified male sex (hazard ratio [HR], 8.48; 95% CI, 1.05-68.76) and a CNB finding of malignancy (HR, 8.20; 95% CI, 1.01-66.15) as factors significantly associated with decreased DFS. CNB demonstrated significantly higher sensitivity (89.0%; 95% CI, 81.2%-94.4%) and NPV (97.6%; 95% CI, 95.7%-98.8%) compared to FNA, which had a sensitivity of 45.2% (95% CI, 33.5%-57.3%) and an NPV of 90.8% (95% CI, 87.7%-93.3%).

Conclusion: Preoperative CNB may be predictive of parotid cancer prognosis. Patients receiving a diagnosis of malignancy on preoperative CNB demonstrated a worse prognosis compared to those with a "less-than-malignant" diagnosis. Additionally, CNB exhibited higher sensitivity than FNA in identifying malignancies of the parotid gland.

核心针穿刺活检可预测腮腺癌术前预后。
背景:涎腺肿瘤的诊断具有挑战性,术前假阴性结果往往导致腮腺切除术后意外的恶性诊断。本研究旨在探讨术前核心针活检(CNB)诊断在原发性腮腺切除术患者中的临床应用及其对腮腺癌预后的影响。方法:我们进行了一项回顾性队列研究,涉及2003年至2023年在三级转诊医院接受原发性腮腺肿瘤术前CNB和腮腺切除术的615例患者。其中,102例腮腺切除术后诊断为原发性腮腺恶性肿瘤的患者的生存结果进行了分析。通过单变量和多变量分析评估DFS和预测因素。计算CNB的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和诊断准确性,并与同期547例行超声引导细针穿刺(FNA)和腮腺切除术的患者进行比较。结果:CNB组5年预测DFS为86.9% (95% CI, 79.2%-95.3%)。多变量分析确定男性性别(HR, 8.48;95% CI, 1.05-68.76)和CNB“恶性”(HR, 8.20;95% CI, 1.01-66.15)与DFS降低显著相关。与FNA相比,CNB的敏感性(89.0% [95% CI, 81.2%-94.4%])和NPV (97.6% [95% CI, 95.7%-98.8%])显著更高(敏感性45.2% [95% CI, 33.5%-57.3%]);净现值90.8% [95% ci, 87.7%-93.3%])。结论:术前CNB可预测腮腺癌的预后。术前诊断为CNB“恶性”的患者与诊断为“非恶性”的患者相比,预后较差。CNB在检测腮腺恶性肿瘤方面也表现出比FNA更高的敏感性。
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来源期刊
CiteScore
4.90
自引率
6.70%
发文量
49
审稿时长
6-12 weeks
期刊介绍: Clinical and Experimental Otorhinolaryngology (Clin Exp Otorhinolaryngol, CEO) is an international peer-reviewed journal on recent developments in diagnosis and treatment of otorhinolaryngology-head and neck surgery and dedicated to the advancement of patient care in ear, nose, throat, head, and neck disorders. This journal publishes original articles relating to both clinical and basic researches, reviews, and clinical trials, encompassing the whole topics of otorhinolaryngology-head and neck surgery. CEO was first issued in 2008 and this journal is published in English four times (the last day of February, May, August, and November) per year by the Korean Society of Otorhinolaryngology-Head and Neck Surgery. The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of otorhinolaryngology field. The readership contains clinical/basic research into current practice in otorhinolaryngology, audiology, speech pathology, head and neck oncology, plastic and reconstructive surgery. The readers are otolaryngologists, head and neck surgeons and oncologists, audiologists, and speech pathologists.
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