Nakahara Tadaki, Suzuki Takayuki, Hashimoto Jun, Shigematsu Naoyuki, Tomita Toshiki, Ogawa Kaoru, Kubo Atsushi
Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Clin Nucl Med. 2007 May;32(5):363-6. doi: 10.1097/01.rlu.0000259323.04488.18.
Although salivary gland scintigraphy has been useful for the diagnosis of Warthin's tumor (WT), there are no reports concerning the clinical impact of this scintigraphy.
We retrospectively investigated 127 patients with solitary parotid tumors who had undergone salivary gland scintigraphy.
For patients who had surgery, the sensitivity, specificity, and accuracy of differentiating WT from non-WTs were 95%, 91%, and 92%, respectively. There was a significant correlation between scintigraphic results and the treatment decisions made for the 127 patients (chi2=16.5, P=0.00026). The proportion of WT patients among those who underwent surgery was 19%, whereas 42% of those who were suspected to have WT from scintigraphy were followed without surgical intervention. The main reasons for clinical observation in these patients were comorbidity, refusal of surgery, and age.
The high percentage of nonsurgical patients suspected to have WT can be explained by the high diagnostic accuracy of salivary gland scintigraphy, which is useful for determining further management when surgery is contraindicated or is refused by the patient.
尽管唾液腺闪烁扫描术对沃辛瘤(WT)的诊断有用,但尚无关于该闪烁扫描术临床影响的报道。
我们回顾性研究了127例接受唾液腺闪烁扫描术的腮腺孤立性肿瘤患者。
对于接受手术的患者,鉴别WT与非WT的敏感性、特异性和准确性分别为95%、91%和92%。闪烁扫描结果与127例患者的治疗决策之间存在显著相关性(卡方=16.5,P=0.00026)。接受手术的患者中WT患者的比例为19%,而闪烁扫描怀疑患有WT的患者中有42%未接受手术干预而是进行随访观察。这些患者进行临床观察的主要原因是合并症、拒绝手术和年龄因素。
唾液腺闪烁扫描术诊断准确性高,可以解释为什么有较高比例疑似WT的患者未接受手术。当手术禁忌或患者拒绝手术时,该检查有助于确定进一步的治疗方案。