背景:细胞学报告对于头颈部外科医生和细胞病理学家诊断和管理腮腺(PG)疾病始终是一个挑战,因为病变之间的各种相似特征。
目的:本研究使用米兰唾液细胞病理学报告系统(MSRSGC)评估我们的实践,并评估不同类别恶性肿瘤(ROM)的风险。
方法:经临床检查确诊为腮腺病变的患者,超声,和FNAC于2019年5月1日至2021年4月30日在我们医院接受超声指导。根据米兰制度,FNAC的结果分为六类。我们根据组织病理学随访计算了米兰系统每个类别的ROM。
结果:本研究包括204例患者。有115名男性(56%),年龄在46-60岁之间。病理结果恶性33例,良性182例。根据MSRSGC,每个类别的恶性肿瘤率为23.1%(非肿瘤性),20%(非典型),50%(肿瘤),1%(良性),10.3%(唾液肿瘤不确定的肿瘤潜能),84.6%(可疑恶性肿瘤),和100%(恶性)类别。灵敏度,特异性,正预测值,应用米兰系统的FNAC的阴性预测值和准确性分别为90.9%,98.2%,90.9%,98.9%和97%。
结论:当米兰系统被应用时,FNAC有很高的疗效,表明MSRSGC可以改善细胞病理学家和外科医生之间的沟通。该系统可以允许外科医生决定手术的程度。
BACKGROUND: A cytology report is always a challenge for both head and neck surgeons and cytopathologists to diagnose and manage parotid gland (PG) diseases, because of the various similar features between the lesions.
OBJECTIVE: The present study was conducted to assess our practice using the Milan System for Reporting Salivary Cytopathology (MSRSGC) and to evaluate the risk of malignancy (ROM) in different categories.
METHODS: The patients with parotid gland lesions were diagnosed by clinical examination, ultrasound, and FNAC under ultrasound guidance at our hospital from 1 May 2019 to 30 April 2021. The FNAC results were divided into six categories according to the Milan system. We calculated the ROM for each category of the Milan system based on histopathological follow-up.
RESULTS: This study included 204 patients. There were 115 men (56 %) aged 46-60 years. Pathology results were 33 cases for malignant and 182 cases for benign. The rate of malignancy for each category according to the MSRSGC were 23.1 % (non-neoplastic), 20 % (atypical), 50 % (neoplastic), 1 % (benign), 10.3 % (salivary neoplasm of uncertain neoplastic potential), 84.6 % (suspicious for malignancy), and 100 % (malignant) categories. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC with application of Milan system were respectively 90.9 %, 98.2 %, 90.9 %, 98.9 % and 97 %.
CONCLUSIONS: When the Milan system was applied, FNAC had a high efficacy, suggesting that MSRSGC can improve the communication between the cytopathologist and the surgeon. This system can allow the surgeon to decide the extent of the surgery.