Gajanin Radoslav, Djurdjević Dejan, Usaj Slavica Knezević, Eri Zivka, Ljubojević Vesna, Karalić Marinko, Risović Tatjana
Vojnosanit Pregl. 2014 Nov;71(11):1018-25. doi: 10.2298/vsp1411018g.
BACKGROUND/AIM: Interpretation of cytological material obtained by fine needle aspiration (FNA) of salivary glands is one of the most challenging areas in cytopathology. FNA is performed easily, it is minimally invasive, inexpensive, fast, reliable and provides valuable information to clinicians about the nature of the lesion and therapeutic modalities. Ex tempore diagnosis, frozen section (FS) is a diagnostic tool that is essential in determining the modalities of surgical treatment of lesions of the salivary glands. Today this method is used in determining the status of resection margins and infiltration of adjacent anatomical structures. The aim of this study was to present our experiences in the application of FNA and FS in the diagnosis of salivary gland lesions and to determine the sensitivity, specificity, predictive value, and diagnostic reliability of these methods.
The study included 36 patients. In all the patients, cytological analysis was done before surgery and histological analysis of the surgical material. In 23 of the patients the FS diagnostics was done. Then we compared FNA and FS findings with histopathological findings.
Correlation of cytological and histological diagnosis showed sensitivity of 83.3%, specificity 96.67%, positive predictive value 83.3%, negative predictive value of 96.77% and diagnostic accuracy of 97.2%. Based on the relationship between FS diagnosis and histopathological diagnosis, the sensitivity was 100%, specificity 96.67%, while positive predictive value and diagnostic accuracy were 100% each.
The study confirmed that FNA is a sensitive, reliable diagnostic method for differentiation of lesions of the salivary glands. In cases with no posibility to definite differentiation in FNA samples, and with the need to assess the resection margins and invasion of anatomical structures, it is recommended to use FS diagnostics.
背景/目的:对唾液腺细针穿刺(FNA)获取的细胞学材料进行解读是细胞病理学中最具挑战性的领域之一。FNA操作简便、微创、成本低、速度快、可靠,能为临床医生提供有关病变性质和治疗方式的有价值信息。即时诊断,即冰冻切片(FS),是确定唾液腺病变手术治疗方式必不可少的诊断工具。如今,该方法用于确定切除边缘的状态以及相邻解剖结构的浸润情况。本研究的目的是介绍我们在FNA和FS应用于唾液腺病变诊断方面的经验,并确定这些方法的敏感性、特异性、预测价值和诊断可靠性。
该研究纳入了36例患者。所有患者在手术前均进行了细胞学分析,并对手术材料进行了组织学分析。其中23例患者进行了FS诊断。然后我们将FNA和FS的结果与组织病理学结果进行了比较。
细胞学与组织学诊断的相关性显示敏感性为83.3%,特异性为96.67%,阳性预测值为83.3%,阴性预测值为96.77%,诊断准确性为97.2%。基于FS诊断与组织病理学诊断之间的关系,敏感性为100%,特异性为96.67%,而阳性预测值和诊断准确性均为100%。
该研究证实FNA是一种用于鉴别唾液腺病变的敏感、可靠的诊断方法。在FNA样本无法明确鉴别的情况下,以及需要评估切除边缘和解剖结构浸润情况时,建议使用FS诊断。