背景:米兰唾液腺细胞病理学报告系统(MSRSGC)是一种风险分层报告系统,于2018年推出。这项多机构研究的目的是评估MSRSGC在日本的实用性。
方法:总共,从日本的12个大型机构中检索了1608个具有匹配组织学诊断的细针抽吸样本。MSRSGC的诊断类别进行了前瞻性或回顾性分配,并将结果与组织学诊断进行比较。
结果:病例分类如下:非诊断性,18.1%;非肿瘤性,4.1%;非典型性意义不明,11.5%;肿瘤-良性,43.7%;涎腺肿瘤恶性潜能不明确,9.6%;可疑恶性肿瘤,3.6%;和恶性,9.4%。每个MSRSGC类别的肿瘤风险和恶性肿瘤风险如下:非诊断性,72.9%和13.4%,分别;非肿瘤性,15.2%和9.1%,分别;意义不确定的非典型性,77.9%和24.9%,分别;肿瘤-良性,99%和1.8%,分别;不确定恶性潜能的涎腺肿瘤,94.8%和37%,分别;怀疑恶性肿瘤,100%和89.7%,分别;和恶性,100%和99.3%,分别。MSRSGC诊断肿瘤的准确率为97.8%,诊断恶性肿瘤的准确率为97.3%。使用Romanowsky染色制剂的机构在非肿瘤类别中具有较低的非诊断率和较低的肿瘤和恶性肿瘤风险。
结论:MSRSGC可用于风险分层和质量控制。MSRSGC的广泛使用将提高唾液腺细胞学的准确性,并在日本带来更好的患者护理。
BACKGROUND: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a risk-stratification reporting system that was introduced in 2018. The objective of this multi-institutional study was to evaluate the utility of the MSRSGC in Japan.
METHODS: In total, 1608 fine-needle aspiration samples with matching histologic diagnoses were retrieved from 12 large institutions in Japan. The diagnostic categories of the MSRSGC were assigned prospectively or retrospectively, and the results were compared with the histologic diagnoses.
RESULTS: The cases were classified as follows: nondiagnostic, 18.1%; non-neoplastic, 4.1%; atypia of undetermined significance, 11.5%; neoplasm-benign, 43.7%; salivary gland neoplasm of uncertain malignant potential, 9.6%; suspicious for malignancy, 3.6%; and malignant, 9.4%. The risk of neoplasm and the risk of malignancy in each MSRSGC category were as follows: nondiagnostic, 72.9% and 13.4%, respectively; non-neoplastic, 15.2% and 9.1%, respectively; atypia of undetermined significance, 77.9% and 24.9%, respectively; neoplasm-benign, 99% and 1.8%, respectively; salivary gland neoplasm of uncertain malignant potential, 94.8% and 37%, respectively; suspicious for malignancy, 100% and 89.7%, respectively; and malignant, 100% and 99.3%, respectively. The accuracy of the MSRSGC for diagnosing neoplasms was 97.8%, and its accuracy for diagnosing malignancy was 97.3%. Institutions that used Romanowsky-stained preparations had lower nondiagnostic rates and lower risks of neoplasm and malignancy in the non-neoplastic category.
CONCLUSIONS: The MSRSGC is useful for risk stratification and quality control. Widespread use of the MSRSGC would improve the accuracy of salivary gland cytology and lead to better patient care in Japan.