儿童患者唾液腺肿瘤的诊断和治疗可能具有挑战性。尚未系统地评估该年龄组的细针抽吸(FNA)细胞病理学的实用性以及米兰唾液腺细胞病理学报告系统(MSRSGC)的性能。数据的匮乏导致FNA细胞病理学在这些患者的术前管理中的有争议的作用。
作者回顾性分析了104例小儿唾液腺FNA(2000-2020)。进行了与可用的组织病理学随访(n=54)的相关性。分布百分比,肿瘤风险(RON),并对MSRSGC的每个类别评估恶性肿瘤(ROM)的风险。
整体灵敏度,特异性,负预测值,儿童唾液腺FNA的阳性预测值为80%,97%,92%,分别。非诊断的RON值,非肿瘤性,不确定意义的非典型性,良性肿瘤,不确定恶性潜能的涎腺肿瘤,怀疑是恶性肿瘤,恶性类别占60%,11%,100%,100%,100%,100%,100%,分别,而ROM值为0%,11%,100%,6%,67%,100%,100%,分别。与成年人相比,非肿瘤性FNA的百分比更高(52%对8%)。0至10岁患者的所有肿瘤均为恶性,而良性肿瘤仅发生在≥11岁的患者中;这支持年龄与唾液腺肿瘤恶性率之间的负相关。
FNA细胞病理学在鉴别儿童涎腺恶性和良性病变方面具有优异的诊断性能。MSRSGC是标准化这些病变的报告和术前风险分层的有价值的工具。
The diagnosis and management of salivary gland tumors in pediatric patients can be challenging. The utility of fine-needle aspiration (FNA) cytopathology and the performance of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) in this age group have not been systematically assessed. The paucity of data has contributed to the controversial role of FNA cytopathology in the presurgical management of these patients.
The authors retrospectively analyzed 104 pediatric salivary gland FNAs (2000-2020). A correlation with the available histopathologic follow-up (n = 54) was performed. The distribution percentages, the risk of neoplasm (RON), and the risk of malignancy (ROM) were assessed for each category of the MSRSGC.
The overall sensitivity, specificity, negative predictive value, and positive predictive value of pediatric salivary gland FNAs were 80%, 97%, and 92%, respectively. The RON values for the nondiagnostic, nonneoplastic, atypia of undetermined significance, benign neoplasm, salivary gland neoplasm of uncertain malignant potential, suspicious for malignancy, and malignant categories were 60%, 11%, 100%, 100%, 100%, 100%, and 100%, respectively, whereas the ROM values were 0%, 11%, 100%, 6%, 67%, 100%, and 100%, respectively. The percentage of nonneoplastic FNAs was greater in comparison with the adult population (52% vs 8%). All neoplasms in patients aged 0 to 10 years were malignant, whereas benign neoplasms occurred only in patients aged ≥11 years; this supported an inverse correlation between age and malignancy rate in salivary gland neoplasms.
FNA cytopathology demonstrates excellent diagnostic performance in differentiating malignant and benign pediatric salivary gland lesions. The MSRSGC is a valuable tool for standardization of the reporting and preoperative risk stratification of these lesions.