细针穿刺细胞学诊断唾液腺分泌性癌的有效性:系统回顾与荟萃分析。

IF 1.6 4区 医学 Q3 PATHOLOGY
Acta Cytologica Pub Date : 2024-01-01 Epub Date: 2024-01-16 DOI:10.1159/000536249
Pooja Sharma Kala, Mamta Gupta, Naveen Thapliyal
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引用次数: 0

摘要

背景:细针穿刺标本中唾液腺分泌性癌(SC)的诊断极具挑战性,因为它的低分化特性使其很难与各种良性或恶性唾液腺肿瘤相鉴别。目前,金标准是显示 ETV6-NTRK3 融合基因。然而,正确认识涎腺癌的细胞形态学特征有助于决定是否进行这种昂贵的分子检测:主要目的是确定细针穿刺细胞学(FNAC)诊断唾液腺 SC 的准确性。次要目的是识别不同的细胞形态学模式、SC 的特征并将其与其他肿瘤区分开来:方法:检索 PubMed/MEDLINE、Science Direct、Embase、Cochrane review 和 PROSPERO 数据库中 2010 年至 2023 年 6 月期间发表的、包含以下关键检索词的研究:("涎腺分泌性癌 "或 "涎腺乳腺类似分泌性癌")和("细胞学 "或 "细胞学特征 "或 "抽吸物 "或 "细胞诊断")。报告涎腺肿瘤细胞学特征并经分子检查证实/诊断为分泌性癌的研究被纳入系统综述。最后,17 项报告了 45 个病例的研究被纳入荟萃分析:FNAC诊断唾液腺分泌性癌的灵敏度为27.7%(95% CI16.6-42.5%)。LR+(阳性似然比)为0.654(0.344-1.245),LR-(阴性似然比)为1.023(0.538-1.946),诊断几率比为0.421(0.129-1.374)。在细胞块上进行分子检测和/或免疫组化可提高诊断准确率:结论:大多数病例的特征性发现是识别出细微的细胞形态学模式,即乳头状形成、细胞簇和单个分散的细胞,以及存在细小的胞浆内空泡,并经诊断性分子图谱分析证实。这可能有助于鉴别这种已发表文献有限的罕见疾病,并有助于提高诊断的准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of Fine-Needle Aspiration Cytology in Diagnosing Secretory Carcinoma of Salivary Gland: A Systematic Review and Meta-Analysis.

Introduction: The diagnosis of salivary gland secretory carcinoma (SC) in fine-needle aspiration specimens is challenging because its low-grade nature makes it difficult to differentiate it from various benign or malignant salivary gland neoplasms. Currently, the gold standard is demonstration of ETV6-NTRK3 fusion gene. However, the decision for ordering this costly molecular testing can be facilitated by the correct recognition of its cytomorphological features. The aim of the review was to determine the accuracy of fine-needle aspiration cytology (FNAC) in diagnosis of salivary gland SC. The secondary objective was to recognize varied cytomorphological patterns, characteristic features of SC and differentiate it from other neoplasms.

Methods: PubMed/MEDLINE, Science Direct, Embase, Cochrane review, and PROSPERO databases were searched for studies having the following key search terms: ("secretory carcinoma of salivary gland" OR "mammary analogue secretory carcinoma of salivary gland") AND ("Cytology" OR "Cytological features" OR "aspirate" OR "cytodiagnosis") published in the time frame of 2010 to June 2023. Studies reporting cytological features of the salivary gland tumors which were confirmed/diagnosed as SC on molecular investigation, were included in the systematic review. Finally, seventeen studies reporting a total of 45 cases were included in the metanalysis.

Results: The sensitivity of the FNAC in diagnosing SC in salivary gland is 27.7% (95% CI: 16.6-42.5%). The LR+ (positive likelihood ratio) was 0.654 (0.344-1.245), LR- (negative likelihood ratio) was 1.023 (0.538-1.946), and diagnostic odds ratio was 0.421 (0.129-1.374). The molecular testing and/or immunohistochemistry performed on cell block increased the diagnostic accuracy.

Conclusion: Recognition of subtle cytomorphological patterns, i.e., papillary formation, clusters, and singly dispersed cells along with presence of fine intracytoplasmic vacuolations were the characteristic findings in majority of cases, confirmed with diagnostic molecular profiling. This may be helpful in identification of this rare entity with limited published literature and help in increasing diagnostic accuracy.

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来源期刊
Acta Cytologica
Acta Cytologica 生物-病理学
CiteScore
3.70
自引率
11.10%
发文量
46
审稿时长
4-8 weeks
期刊介绍: With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.
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