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细针穿刺细胞学检查(FNAC):它在腮腺病变的术前诊断中有用吗?

Fine-needle aspiration cytology (FNAC): is it useful in preoperative diagnosis of parotid gland lesions?

作者信息

Correia-Sá Inês, Correia-Sá Mário, Costa-Ferreira Pedro, Silva Álvaro, Marques Marisa

机构信息

a Department of Plastic and Reconstructive Surgery , Centro Hospitalar S. João , Porto , Portugal.

b Department of Plastic and Reconstructive Surgery, Faculty of Medicine , University of Porto , Porto , Portugal.

出版信息

Acta Chir Belg. 2017 Apr;117(2):110-114. doi: 10.1080/00015458.2016.1262491. Epub 2016 Dec 21.

Abstract

BACKGROUND

Salivary gland tumors are an uncommon entity and its histopathology is highly varied due to heterogeneous cellular composition. The role of the preoperative fine-needle aspiration cytology (FNAC) remains controversial. The purpose of this study is to compare the cytologic findings of salivary gland lesions with the histologic diagnoses, in order to assess the usefulness and accuracy of fine-needle aspiration cytology in the diagnosis of parotid gland tumors.

METHODS

A retrospective study was performed, regarding patients (n = 65) submitted to surgery for the treatment of parotid gland disease, who had performed preoperative FNAC, in our department between 2002 and 2012. A histologic diagnosis was considered as the gold standard for the assessment of sensitivity and specificity of FNAC. A cytohistologic correlation was done and appropriate statistical tests were applied.

RESULTS

Concordance between FNAC and histological specimen analysis was 78%. FNAC specificity was 82% and sensitivity was 71%. Positive and negative predictive values were 65% and 86% and positive likelihood ratio and negative likelihood ratio were 3.92 and 0.35, respectively. The diagnostic accuracy for this test was 78%.

CONCLUSION

Preoperative FNAC of parotid lesions is reasonably accurate and useful in diagnosing benign from malignant lesions and in planning appropriate approach for treatment.

摘要

背景

涎腺肿瘤是一种罕见的疾病,由于其细胞组成的异质性,其组织病理学差异很大。术前细针穿刺细胞学检查(FNAC)的作用仍存在争议。本研究的目的是比较涎腺病变的细胞学检查结果与组织学诊断,以评估细针穿刺细胞学检查在腮腺肿瘤诊断中的实用性和准确性。

方法

进行一项回顾性研究,纳入2002年至2012年间在我科接受手术治疗腮腺疾病且术前进行了FNAC的患者(n = 65)。组织学诊断被视为评估FNAC敏感性和特异性的金标准。进行了细胞组织学相关性分析并应用了适当的统计检验。

结果

FNAC与组织学标本分析的一致性为78%。FNAC的特异性为82%,敏感性为71%。阳性和阴性预测值分别为65%和86%,阳性似然比和阴性似然比分别为3.92和0.35。该检查的诊断准确性为78%。

结论

腮腺病变的术前FNAC在诊断良性与恶性病变以及规划适当的治疗方法方面具有合理的准确性和实用性。

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