Ashraf Ameena, Shaikh Afsar Saeed, Kamal Farrukh, Sarfraz Rahat, Bukhari Mulazim Hussain
Department of Pathology, Fatima Jinnah Medical College, Lahore, Pakistan.
Diagn Cytopathol. 2010 Jul;38(7):499-504. doi: 10.1002/dc.21211.
A prospective study was conducted to see the sensitivity, specificity, and accuracy of fine needle aspiration cytology (FNAC) for 100 salivary gland swellings in comparison with biopsy. These randomized samples were submitted and reported at the department of pathology, Allama Iqbal Medical College, Lahore. The male to female ratio was 1:1.5. Ages of the patients ranged from 8.5 to 58 years with mean age 33.39 +/- 12.37 years. Maximum number of lesions was found in age group between 21 and 40 years. Parotid gland was involved in 68%, submandibular gland in 30%, and minor salivary glands in 2% patients. Sublingual gland was not involved in any of our subjects. There were 14% cases of non-neoplastic lesions and 86% cases of neoplastic lesions on biopsy. Non-neoplastic lesions included 12 cases of inflammations (three cases of granulomatous inflammation and nine cases of nonspecific chronic inflammation) and two cases of inclusion cysts. Among neoplastic lesions, biopsy revealed 68 cases of benign neoplasia and 18 cases of malignant neoplasia. Non-neoplastic lesions did not show any difference in diagnosis by both techniques. FNAC misdiagnosed four malignant and one benign lesion. Sensitivity, specificity, positive predictive value, and negative predictive value of FNAC for benign neoplastic lesions were 98.52, 87.05, 94.36, and 96.55%, respectively, whereas for malignant neoplastic lesions they were 77.77, 98.78, 93.33, and 95.29%, respectively. In conclusion, FNAC is found to be a highly sensitive and specific technique for diagnosis of most of salivary gland swellings, except for malignant neoplastic lesions where its sensitivity is intermediate. We strongly recommend that FNAC should be adopted as an initial investigation for all salivary gland swellings.
开展了一项前瞻性研究，以观察细针穿刺细胞学检查（FNAC）对100例唾液腺肿大的敏感性、特异性和准确性，并与活检进行比较。这些随机样本提交至拉合尔阿拉马·伊克巴尔医学院病理科并进行报告。男女比例为1:1.5。患者年龄范围为8.5至58岁，平均年龄为33.39±12.37岁。21至40岁年龄组的病变数量最多。68%的患者累及腮腺，30%累及下颌下腺，2%累及小唾液腺。我们的研究对象中未累及舌下腺。活检显示14%为非肿瘤性病变，86%为肿瘤性病变。非肿瘤性病变包括12例炎症（3例肉芽肿性炎症和9例非特异性慢性炎症）和2例包涵囊肿。在肿瘤性病变中，活检显示68例良性肿瘤和18例恶性肿瘤。两种技术对非肿瘤性病变的诊断无差异。FNAC误诊了4例恶性病变和l例良性病变。FNAC对良性肿瘤性病变的敏感性、特异性、阳性预测值和阴性预测值分别为98.52%、87.05%、94.36%和96.55%，而对恶性肿瘤性病变的敏感性、特异性、阳性预测值和阴性预测值分别为77.77%、98.78%、93.33%和95.29%。总之，除了恶性肿瘤性病变的敏感性为中等外，FNAC被发现是诊断大多数唾液腺肿大的高度敏感和特异的技术。我们强烈建议将FNAC作为所有唾液腺肿大的初始检查方法。
