Wei Shuanzeng, Layfield Lester J, LiVolsi Virginia A, Montone Kathleen T, Baloch Zubair W
Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, 19111.
Department of Pathology & Anatomical Sciences, M263 Medical Science Building, One Hospital Drive, University of Missouri, Columbia, Missouri, 65212.
Diagn Cytopathol. 2017 Sep;45(9):820-827. doi: 10.1002/dc.23716. Epub 2017 Mar 31.
Currently, there is no uniform classification scheme available for reporting of salivary gland fine-needle aspiration (FNA) specimens. Recently, an International group of pathologists has recommended a tiered classification scheme for reporting of salivary gland FNA results known as the "Milan System for Reporting Salivary Gland Cytopathology (MSRSGC)." We performed a comprehensive review of the published literature on FNA of salivary gland lesions by employing the diagnostic categories of the MSRSGC to evaluate their reliability in the management of salivary gland lesions. A comprehensive review of the literature was carried out through PubMed from 1987 to 2015 to identify studies which categorized the cytologic diagnoses and included surgical follow-up. Only cases with histopathologic follow-up were included in the analysis. Twenty-nine studies comprising 4514 cases of salivary gland FNAs with surgical follow-up were included in this study. The cytologic diagnoses were categorized into the following categories proposed by MSRSGC. The number of cases in each diagnostic category and the risk of malignancy (ROM) were as follows: Non-Diagnostic-100 cases (ROM- 25.0% ± 16.7%), Non-Neoplastic-587 cases (ROM: 10.2% ± 5.5%), Benign Neoplasm -2673 cases (ROM: 3.4% ± 1.3%), Salivary Gland Neoplasm of Undetermined Malignant Potential (SUMP)-64 cases(ROM: 37.5% ± 24.7%), Suspicious for Malignant neoplasm-70 cases(ROM: 58.6% ± 19.5%), and Malignant-1012 cases(ROM: 91.9% ± 3.5%). A tiered classification scheme as proposed by MSRSGC may prove helpful in effectively guiding clinical management of patients with salivary gland lesions.
目前，尚无统一的分类方案用于报告唾液腺细针穿刺（FNA）标本。最近，一个国际病理学家小组推荐了一种用于报告唾液腺FNA结果的分级分类方案，即“米兰唾液腺细胞病理学报告系统（MSRSGC）”。我们采用MSRSGC的诊断类别对已发表的关于唾液腺病变FNA的文献进行了全面综述，以评估其在唾液腺病变管理中的可靠性。通过PubMed对1987年至2015年的文献进行了全面综述，以确定对细胞学诊断进行分类并包括手术随访的研究。分析仅纳入有组织病理学随访的病例。本研究纳入了29项研究，共4514例有手术随访的唾液腺FNA病例。细胞学诊断分为MSRSGC提出的以下类别。每个诊断类别的病例数和恶性风险（ROM）如下：无法诊断-100例（ROM-25.0%±16.7%），非肿瘤性-587例（ROM：10.2%±5.5%），良性肿瘤-2673例（ROM：3.4%±1.3%），恶性潜能未定的唾液腺肿瘤（SUMP）-64例（ROM：37.5%±24.7%），可疑恶性肿瘤-70例（ROM：58.6%±19.5%），恶性-1012例（ROM：91.9%±3.5%）。MSRSGC提出的分级分类方案可能有助于有效指导唾液腺病变患者的临床管理。
