Application of the Milan and IAC–IARC–WHO Systems in diagnosing soft tissue and bone tumors of the salivary glands: The Institut Curie experience

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology Pub Date : 2025-08-20 DOI:10.1002/cncy.70040

Adam Kowalewski MD, PhD, MIAC, Jędrzej Borowczak MD, PhD, Hervé J. Brisse MD, PhD, Olivier Choussy MD, Jerzy Klijanienko MD, PhD, MIAC

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Abstract

Background

Soft tissue and bone tumors of the salivary gland were compared using classic 4-tier, Milan System for Reporting Salivary Gland Cytopathology (MSRSGC), and the International Academy of Cytology-International Agency for Research on Cancer-World Health Organization (IAC–IARC–WHO) Reporting System for Soft Tissue Cytopathology.

Methods

The authors retrospectively analyzed 2219 salivary gland fine-needle aspiration (FNA) samples collected at the Institut Curie in Paris between 1954 and 2022. A total of 86 cases (3.9%) were identified as soft tissue and bone tumors, with histological follow-up in 63 cases (73%). Cytology was classified according to the classic European 4-tier system, the MSRSGC, and the IAC–IARC–WHO System.

Results

According to the MSRSGC, eight cases were classified as nonneoplastic, 30 as benign, one as salivary gland neoplasm of uncertain malignant potential, five as suspicious for malignancy, and 42 as malignant. Benign or malignant nature was accurately assessed in 78 cases (90.7%), with exact histologic-cytologic concordance in 51 cases (59.3%). FNA correctly identified 42 of 44 malignant tumors (95.5%), with exact diagnostic matches in 30 cases (68.2%). The MSRSGC achieved 88.3% overall accuracy, 93.6% sensitivity, and 82.7% specificity. Risk of malignancy (ROM) was comparable for malignant tumors across the classic European system, the MSRSGC, and the IAC–IARC–WHO System, with minor discrepancies observed in benign and indeterminate categories. No cases were assigned as nondiagnostic, atypia of undetermined significance, atypical.

Conclusions

Despite their rarity, soft tissue and bone tumors of the salivary gland can be effectively diagnosed using the MSRSGC, with a high accuracy achieved for malignant cases. Minor discrepancies in ROMs were observed between specific categories of the classic European system, the MSRSGC, and the IAC–IARC–WHO System.

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应用Milan和IAC-IARC-WHO系统诊断唾液腺软组织和骨肿瘤：居里研究所的经验

研究背景：采用经典的4级系统，即米兰唾液腺细胞病理学报告系统（MSRSGC）和国际细胞学学会-国际癌症研究机构-世界卫生组织（IAC-IARC-WHO）软组织细胞病理学报告系统对唾液腺软组织和骨肿瘤进行比较。方法回顾性分析1954年至2022年在巴黎居里研究所采集的2219例涎腺细针抽吸（FNA）样本。软组织及骨肿瘤86例（3.9%），经组织学随访63例（73%）。细胞学根据经典的欧洲4层系统、MSRSGC和IAC-IARC-WHO系统进行分类。结果根据MSRSGC，非肿瘤性8例，良性30例，恶性潜能不确定的唾液腺肿瘤1例，可疑恶性5例，恶性42例。良恶性78例（90.7%），组织学-细胞学诊断51例（59.3%）。44例恶性肿瘤中，FNA正确诊断42例（95.5%），准确诊断匹配30例（68.2%）。MSRSGC的总体准确度为88.3%，灵敏度为93.6%，特异性为82.7%。恶性肿瘤的风险（ROM）在经典的欧洲系统、MSRSGC和IAC-IARC-WHO系统中具有可比性，在良性和不确定类别中观察到轻微差异。没有病例被指定为非诊断性，不确定意义的非典型，非典型。结论涎腺软组织和骨肿瘤虽罕见，但MSRSGC能有效诊断，对恶性肿瘤的诊断准确率较高。在经典欧洲系统、MSRSGC和IAC-IARC-WHO系统的特定类别之间观察到rom的微小差异。

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来源期刊

Cancer Cytopathology 医学-病理学

CiteScore

7.00

自引率

17.60%

发文量

130

审稿时长

1 months

期刊介绍： Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.