提高腮腺肿块FNAC的诊断准确性和临床效果。

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Diagnostic Cytopathology Pub Date : 2024-12-02 DOI:10.1002/dc.25426

Fatih Mutlu, Busra Yaprak Bayrak, Murat Ozturk

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引用次数: 0

摘要

背景：包括肿瘤和非肿瘤条件的腮腺肿块目前的诊断挑战。细针穿刺细胞学（FNAC）通常用于区分良性和恶性病变，但存在敏感性可变和潜在采样误差等局限性。本研究评估了FNAC对腮腺病变的准确性，评估了米兰唾液腺细胞病理学报告系统（MSRSGC），并将FNAC结果与组织病理学结果进行了比较。方法：本回顾性研究分析了2321例腮腺FNAC术后20年切除术患者的资料。如果患者在2004年1月至2024年7月期间进行了细胞学分析和手术，则纳入其中。手术方法根据肿块特征和FNAC结果而有所不同，所有样本均使用MSRSGC进行评估。统计分析比较FNAC结果与组织病理学结果，计算敏感性、特异性和准确性。结果：本研究包括352例同时行FNAC和手术切除的患者。FNAC的总体准确率为93.9%，敏感性为78.3%，特异性为91.5%。米兰I类（非诊断性）的恶性风险为30%，II类（非肿瘤性）为6.3%，III类（不确定意义的异型性）为0%，IVa类（良性肿瘤）为2.3%，IVb类（不确定恶性潜能的肿瘤）为5.8%，V类（可疑恶性肿瘤）为58.8%，VI类（恶性）为95%。假阴性率为2.4%，假阳性率为3.4%。恶性肿瘤风险随年龄增长而增加，恶性肿块越大，越容易引起面瘫。结论：FNAC是诊断腮腺肿块的重要工具，具有较高的特异性和准确性，但存在一定的局限性。年龄小且病史不恰当的患者应更仔细地评估。MSRSGC是一个有用的系统，显示适当的恶性风险。

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Enhancing Diagnostic Precision and Clinical Outcomes With FNAC in Parotid Gland Masses

Background

Parotid gland masses encompassing both neoplastic and non-neoplastic conditions present diagnostic challenges. Fine-needle aspiration cytology (FNAC) is commonly used to differentiate between benign and malignant lesions but has limitations such as variable sensitivity and potential sampling errors. This study assesses FNAC's accuracy for parotid gland lesions, evaluates the Milan Salivary Gland Cytopathology Reporting System (MSRSGC), and compares FNAC results with histopathological findings.

Methods

This retrospective study at our medical center analyzed data from 2321 patients who underwent parotid gland FNAC followed by surgical resection over 20 years. Patients were included if they had both cytological analysis and surgery between January 2004 and July 2024. Surgical procedures varied based on mass characteristics and FNAC results, and all samples were assessed using MSRSGC. Statistical analysis compared FNAC results with histopathology findings, calculating sensitivity, specificity, and accuracy.

Results

This study included 352 patients who underwent both FNAC and surgical resection. FNAC had an overall accuracy of 93.9%, with a sensitivity of 78.3% and specificity of 91.5%. The risk of malignancy was 30% for Milan Category I (nondiagnostic), 6.3% for Category II (non-neoplastic), 0% for Category III (Atypia of Undetermined Significance), 2.3% for Category IVa (benign neoplasm), 5.8% for Category IVb (neoplasm of uncertain malignant potential), 58.8% for Category V (suspicious for malignancy), and 95% for Category VI (malignant). The false negative rate was 2.4%, while the false positive rate was 3.4%. The malignancy risk increased with age, and malignant masses were larger and more likely to cause facial paralysis.

Conclusion

FNAC is a key diagnostic tool for parotid gland masses, offering high specificity and accuracy despite some limitations. Patients with young ages and inappropriate histories should be assessed more carefully. MSRSGC is a useful system to show appropriate risk of malignancy.

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来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.