背景:术前常规通过细针穿刺细胞学(FNAC)评估唾液腺病变。米兰唾液腺细胞病理学报告系统(MSRSGC)已标准化唾液腺FNAC报告。它在主要唾液腺(MSG)中的应用已经得到了完善;然而,其在小唾液腺(MiSGs)中的效用尚不为人所知。我们研究了MSRSGC在MiSGFNAC中的实用性。
方法:对来自2个学术机构(2006-2023年)的MiSGFNAC进行了回顾性搜索。使用MSRSGC对FNAC进行分类。回顾并记录组织学数据。恶性肿瘤(ROM)的风险,肿瘤形成的风险(RON),诊断准确性,灵敏度,特异性,阳性预测值(PPV),并计算阴性预测值(NPV)。
结果:该系列包括43位MiSGFNAC(24位男性和18位女性),平均年龄55岁(范围10-92)。误吸部位包括:腭,颊空间,嘴巴的地板,唇,舌头,上颌窦.FNAC被归类为非诊断性(1),非肿瘤性(3),不确定意义的非典型性(6),良性肿瘤(9),不确定恶性潜能的涎腺肿瘤(15),怀疑是恶性肿瘤,(2)和恶性(7)。肿瘤形成的风险和恶性肿瘤的风险分别为87%和39%。诊断的准确性,灵敏度,特异性,正预测值,阴性预测值为100%,分别。
结论:米兰唾液腺细胞病理学报告系统为MiSG病变的分层提供了有价值的信息。然而,所遇到的诊断实体的分布和范围与MSG有所不同。例如,粘液囊肿内容物可能需要在MiSG中进行独特的考虑;而MSG中建议使用非典型分类,MiSG中黏液囊肿的高患病率可能使该组倾向于良性。
BACKGROUND: Salivary gland lesions are routinely evaluated by fine-needle aspiration cytology (FNAC) preoperatively. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) has standardized salivary gland FNAC reporting. Its application in major salivary glands (MSGs) has been well-established; however, its utility in minor salivary glands (MiSGs) is not well-known. We studied the utility of MSRSGC in MiSG FNAC.
METHODS: A retrospective search of MiSG FNACs from 2 academic institutions (2006-2023) was performed. FNACs were classified using the MSRSGC. Histologic data were reviewed and recorded. The risk of malignancy (ROM), risk of neoplasia (RON), diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.
RESULTS: The series included 43 MiSG FNAC (24 males and 18 females), with a mean age of 55 years (range 10-92). Aspirated sites included the following: palate, buccal space, floor of mouth, lip, tongue, and maxillary sinus. FNACs were classified as nondiagnostic (1), nonneoplastic (3), atypia of undetermined significance (6), benign neoplasm (9), salivary gland neoplasm of uncertain malignant potential (15), suspicious for malignancy, (2) and malignant (7). The risk of neoplasia and risk of malignancy were 87% and 39%. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 100%, respectively.
CONCLUSIONS: Milan System for Reporting Salivary Gland Cytopathology offers valuable information for stratifying MiSG lesions. However, the distribution and the range of diagnostic entities encountered differ somewhat from those in MSGs. For instance, mucinous cyst contents may warrant unique consideration in MiSG; while an atypical classification is recommended in MSGs, the high prevalence of mucoceles in MiSG may tilt this group toward benignity.