背景:唾液腺肿瘤的诊断具有挑战性,特别是通过细针抽吸获得的细胞学标本。最近实施的用于报告唾液腺细胞病理学的标准化米兰系统提供了恶性肿瘤(ROM)的估计风险;然而,对于两个类别,病变的诊断仍不清楚.然而,精确的诊断对于优化患者管理是可取的,包括手术和成像程序的规划。
方法:使用SalvGlandDx面板对细胞学样本(n=106)进行分子分析。根据切除标本的诊断,计算每个检测到的改变的恶性肿瘤风险。考虑到分子的变化,它们相关的ROM,临床和细胞学特征,和当前的文学,米兰类别进行了评估。
结果:在n=63个技术上有效的案例中,76%显示分子改变。当额外考虑分子结果时,总共94%的这些分子改变病例可以被分配到不同的米兰类别。在只有2%的唾液腺肿瘤的不确定的恶性潜力,其中检测到分子改变,分类仍然是不确定恶性潜能的唾液腺肿瘤。
结论:细胞学标本的分子分析在细针穿刺对唾液腺肿瘤进行分类方面具有优势。它可以改善ROM估计,因此有助于将以前未知的恶性潜能的病例指定为明确的良性或恶性类别。
BACKGROUND: Diagnosis of salivary gland neoplasms is challenging, especially on cytological specimens acquired by fine-needle aspiration. The recently implemented standardized Milan system for reporting salivary gland cytopathology provides an estimated risk of malignancy (ROM); yet, for two of the categories, the diagnosis of the lesion remains unclear. However, a precise diagnosis is desirable for optimal patient management, including planning of surgery and imaging procedures.
METHODS: Cytological specimens (n = 106) were subjected to molecular analysis using the SalvGlandDx panel. The risk of malignancy was calculated for each detected alteration based on the diagnosis of the resection specimen. By taking into account the molecular alterations, their associated ROM, the clinical and cytological features, and the current literature, the Milan category was evaluated.
RESULTS: Of n = 63 technically valid cases, 76% revealed a molecular alteration. A total of 94% of these molecularly altered cases could be assigned to a different Milan category when additionally taking molecular results into account. In only 2% of the salivary gland neoplasms of uncertain malignant potential, in which a molecular alteration was detected, the classification remained salivary gland neoplasms of uncertain malignant potential.
CONCLUSIONS: Molecular analysis of cytological specimens provides a benefit in classifying salivary gland neoplasms on fine-needle aspiration. It can improve the ROM estimation and thus help to assign cases of formerly unknown malignant potential to clearly benign or malignant categories.