Ostović Karmen Trutin, Luksić Ivica, Virag Miso, Macan Darko, Müllers Danko, Manojlović Spomenka
University of Zagreb, Dubrava University Hospital, Department of Clinical Cytology and Cytometry, Zagreb, Croatia.
Coll Antropol. 2012 Nov;36 Suppl 2:151-7.
Tumours arising from oral minor salivary glands may exhibit an overlap of clinical and morphological features that may produce diagnostic and therapeutic dilemmas. The aim of this study is to asses the value of fine needle aspiration cytology (FNAC) in differentiation of benign and malignant tumours and to render a specific diagnosis. We evaluated the team work of surgeon and cytologist to improve diagnostic accuracy. Two steps are important for accuracy: sampling aspirate that should be done together by surgeon and cytologist and cytological microscopic analysis of the smears that should be performed by an experienced cytologist. The study included 132 patients with intraoral minor salivary gland tumours between 2002 and 2011. Adequate material was obtained from 121 (91.7%) patients. FNAC was usually performed by cytologist in a team with maxillofacial surgeon at cytology department that is more convenient for preparing the samples and especially for ROSE procedure (rapid-on site evaluation) of smears. In such a way the cytologist checked the adequacy of samples and decided whether some ancillary techniques should be used and therefore repeat FNAC. A total of 82 patients underwent surgery, 40 with malignant and 42 with benign tumours. Preoperative cytological diagnoses were compared with histopathological ones using histopathology as a gold standard. The most common benign tumour was pleomorphic adenoma and among malignant tumours adenoid cystic carcinoma. The most commonly affected site was the palate. The team work of surgeon and cytologist achieved specificity of 95.1%, sensitivity of 97.6% and diagnostic accuracy of 96.3%. We can conclude that although subclassification of some tumour types of salivary glands remains poor, FNAC is invaluable in patient triage and therefore should be considered in the first line investigations of these lesions by the cytologist and surgeon.
起源于口腔小唾液腺的肿瘤可能表现出临床和形态学特征的重叠，这可能导致诊断和治疗上的困境。本研究的目的是评估细针穿刺细胞学检查（FNAC）在鉴别良性和恶性肿瘤以及做出明确诊断方面的价值。我们评估了外科医生和细胞病理学家的团队协作，以提高诊断准确性。准确诊断有两个重要步骤：外科医生和细胞病理学家共同进行的穿刺取样，以及由经验丰富的细胞病理学家对涂片进行细胞学显微镜分析。本研究纳入了2002年至2011年间132例口腔小唾液腺肿瘤患者。121例（91.7%）患者获得了足够的样本。FNAC通常由细胞病理学家与颌面外科医生在细胞学科室共同进行，这样更便于样本制备，尤其是对于涂片的快速现场评估（ROSE程序）。通过这种方式，细胞病理学家可以检查样本的充足性，并决定是否应使用一些辅助技术，从而决定是否重复FNAC。共有82例患者接受了手术，其中40例为恶性肿瘤，42例为良性肿瘤。以组织病理学为金标准，将术前细胞学诊断与组织病理学诊断进行比较。最常见的良性肿瘤是多形性腺瘤，恶性肿瘤中最常见的是腺样囊性癌。最常受累的部位是腭部。外科医生和细胞病理学家的团队协作实现了95.1%的特异性、97.6%的敏感性和96.3%的诊断准确性。我们可以得出结论，尽管某些唾液腺肿瘤类型的亚分类仍然欠佳，但FNAC在患者分流中具有重要价值，因此细胞病理学家和外科医生在对这些病变进行一线检查时应考虑使用。
