Hosokawa Seiji, Takebayashi Satoru, Sasaki Yutaka, Mineta Hiroyuki
Associate Professor, Department of Otorhinolaryngology/Head & Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Vice President, Department of Otorhinolaryngology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
J Oral Maxillofac Surg. 2018 Jul;76(7):1468.e1-1468.e4. doi: 10.1016/j.joms.2018.02.024. Epub 2018 Mar 10.
Methods for cytologic diagnosis, such as fine-needle aspiration (FNA) and touch smear (TS) cytology, have been frequently used for malignant tumor screening; however, false-negative cases often result in misdiagnosis. The purpose of this study was to investigate the causes of false-negative cases and methods to decrease the false-negative rate in salivary gland tumor TS cytology.
In this cross-sectional study, the authors examined pathologically confirmed salivary gland tumors in 127 cases in which FNA and TS cytology were performed before the operation or open biopsy at Numazu City Hospital (Numazu, Japan) from 2002 to 2016. The authors evaluated the false-negative rates of TS and FNA cytology separately and when used in combination and other variables, such as age, gender, sensitivity, accuracy, specificity, and overall pathologic diagnosis by resection.
The overall false-negative rate of postoperative pathologic diagnosis was lower when TS and FNA were combined (1 of 127 cases; 0.8%) compared with FNA cytology alone (10 of 127 cases; 7.9%; P = .034). Suggested causes of a false-negative FNA (or TS) result include cytologic difficulties present in certain malignancies, such as mucoepidermoid carcinoma, adenoid cystic carcinoma, and others.
False-negative cases were decreased when a combination of preoperative FNA and intraoperative TS cytology was performed. TS cytology appears to be a useful method to avoid misdiagnosis in salivary gland diseases.
细胞诊断方法,如细针穿刺抽吸(FNA)和印片细胞学检查(TS),已被频繁用于恶性肿瘤筛查;然而,假阴性病例常常导致误诊。本研究的目的是探讨唾液腺肿瘤印片细胞学检查假阴性病例的原因及降低假阴性率的方法。
在这项横断面研究中,作者检查了2002年至2016年在日本沼津市医院接受手术或开放性活检前进行FNA和TS细胞学检查的127例经病理证实的唾液腺肿瘤病例。作者分别评估了TS和FNA细胞学检查单独使用及联合使用时的假阴性率,以及其他变量,如年龄、性别、敏感性、准确性、特异性和切除后的总体病理诊断。
与单独的FNA细胞学检查(127例中有10例;7.9%;P = 0.034)相比,TS和FNA联合使用时术后病理诊断的总体假阴性率较低(127例中有1例;0.8%)。FNA(或TS)结果假阴性的可能原因包括某些恶性肿瘤(如黏液表皮样癌、腺样囊性癌等)存在的细胞学诊断困难。
术前FNA和术中TS细胞学检查联合使用时假阴性病例减少。印片细胞学检查似乎是避免唾液腺疾病误诊的一种有用方法。