腮腺肿瘤细针穿刺活检：临床视角下的诊断效用
Fine needle aspiration of parotid tumors: diagnostic utility from a clinical perspective.
作者信息
Jeong Woo-Jin, Park Sung Joon, Cha Wonjae, Sung Myung-Whun, Kim Kwang Hyun, Ahn Soon-Hyun
机构信息
Seoul National University Bundang Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
出版信息
J Oral Maxillofac Surg. 2013 Jul;71(7):1278-82. doi: 10.1016/j.joms.2013.01.017. Epub 2013 Mar 26.
PURPOSE
The utility of fine needle aspiration (FNA) for parotid tumors is limited owing to its low diagnostic accuracy. In this study, the authors sought to analyze and interpret FNA results for parotid tumors from a clinical perspective.
MATERIALS AND METHODS
Parotid tumors subjected to preoperative FNA and subsequent complete excision were the subject of this study. Patient demographics, medical records, FNA findings, and final pathology of 158 consecutive cases were analyzed.
RESULTS
The accuracy of FNA was 77.8%. The positive predictive value and likelihood ratio for malignancy were 90.0% and 52.8% (95% confidence interval, 7.02-397), respectively. The positive predictive value and likelihood ratio for benign pathology of Warthin tumor plus pleomorphic adenoma were 97.8% and 7.67% (2.03-29.0), respectively.
CONCLUSIONS
The FNA diagnosis of Warthin tumor or pleomorphic adenoma is reliable and can be safely regarded as a benign tumor. Based on the high positive predictive value and likelihood ratio, FNA of the parotid gland can offer valuable information in surgical planning and patient counseling in many centers.
目的
细针穿刺抽吸活检（FNA）对腮腺肿瘤的诊断价值有限，因其诊断准确性较低。在本研究中，作者试图从临床角度分析和解读腮腺肿瘤的FNA结果。
材料与方法
本研究对象为术前接受FNA并随后进行完整切除的腮腺肿瘤。分析了158例连续病例的患者人口统计学资料、病历、FNA检查结果及最终病理结果。
结果
FNA的准确性为77.8%。恶性肿瘤的阳性预测值和似然比分别为90.0%和52.8%（95%置信区间，7.02 - 397）。沃辛瘤加多形性腺瘤良性病理的阳性预测值和似然比分别为97.8%和7.67%（2.03 - 29.0）。
结论
FNA诊断沃辛瘤或多形性腺瘤是可靠的，可安全地视为良性肿瘤。基于较高的阳性预测值和似然比，在许多中心，腮腺FNA可为手术规划和患者咨询提供有价值的信息。
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