报告唾液腺细胞病理学和更新的米兰系统

Xi Wang, He Wang
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摘要

米兰唾液腺细胞病理学报告系统(MSRSGC)是在5年前引入细胞病理学实践的。它将唾液腺病变分为6个诊断类别,并为每个类别提供恶性肿瘤风险(ROM)和临床管理指南。已有100多篇文章证实了该报告系统在日常实践中的适用性,并为唾液腺细针抽吸提供了统一的报告系统。与此同时,出现了新的问题和改进的反馈,以及澄清的机会。例如,与非诊断类别相关的问题是多重的。首先,尽管非诊断性的细胞学标准目前被定义为“临床背景下明显肿块内病变细胞或正常唾液腺组织<60个”,但这在文献中尚未建立或验证。其次,非诊断类的ROM很高。另一个问题围绕着对当前MSRSGC分类进行细分的有趣话题,因为同一类别的肿瘤的恶性风险可能不同。最后一个是将越来越多的分子标记和基因重排的抗体检测,即所谓的下一代免疫组织化学(IHC)标记纳入常规细胞病理学实践。新一代测序技术在病理学实践中的快速应用为唾液腺细胞病理学诊断提供了令人兴奋的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Milan System for Reporting Salivary Gland Cytopathology and Updates
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced into cytopathology practice more than 5 years ago. It classifies the salivary gland lesion into 6 diagnostic categories and provides the risk of malignancy (ROM) and clinical management guidelines for each category. More than 100 articles have confirmed the applicability of this reporting system in routine practice and its important role in providing a uniform reporting system for salivary gland fine-needle aspiration. At the same time, new questions and feedback for improvement have emerged, as well as opportunities for clarification. For example, questions related to the non-diagnostic category are multiple-fold. First, although the cytologic criterion of the non-diagnostic category is currently defined as “<60 lesional cells or normal salivary gland tissue within the clinical setting of an evident mass”, this has not been established or validated in the literature. Second, the ROM for the non-diagnostic category is high. Another question surrounds the interesting topic of sub-classifying current MSRSGC categories, as the risk of malignancy could vary in tumors of the same category. The last one concerns the incorporation of the ever-increasing number of molecular markers and antibody detection of gene re-arrangements, so-called next-generation immunohistochemistry (IHC) markers, into routine cytopathology practice. The quick application of next-generation sequencing into pathology practice provides an exciting opportunity for salivary gland cytopathology diagnosis.
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