基于米兰系统的腮腺肿瘤细针抽吸细胞学风险分层-亚洲一家三级中心的经验。
Risk stratification of fine-needle aspiration cytology of parotid neoplasms based on the Milan system-Experience from a tertiary center in Asia.
机构信息
Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore.
Department of Pathology, Tan Tock Seng Hospital, Singapore, Singapore.
出版信息
Head Neck. 2019 Sep;41(9):3125-3132. doi: 10.1002/hed.25804. Epub 2019 May 27.
BACKGROUND
The recently described Milan system provides a unified way of categorizing salivary gland fine-needle aspiration (FNA) cytology. We aim to use this system to stratify risk of malignancy in parotid FNAs.
METHODS
In this retrospective case series, 376 FNAs were preoperatively performed for 573 parotidectomies over 14 years.
RESULTS
Risk of malignancy on FNA is as follows: nondiagnostic 14.5%, non-neoplastic 26.7%, atypia of undetermined significance 29.3%, benign neoplasm 2.7%, neoplasm of uncertain malignant potential 19.1%, suspicious for malignancy 87.5%, and malignant 100%. The specific diagnoses of pleomorphic adenoma and Warthin tumor on FNA have high positive predictive value of 97.5% and 96.6%, respectively. Multivariate regression associates smaller size of lesion with a nondiagnostic or indeterminate result. Seniority of operator is associated with a lower likelihood of a nondiagnostic result.
CONCLUSIONS
This large Asian series validates the Milan system as a valuable tool in stratifying malignancy risk of parotid FNAs.
背景
最近描述的米兰系统为唾液腺细针抽吸（FNA）细胞学提供了一种统一的分类方法。我们旨在使用该系统对腮腺 FNA 的恶性肿瘤风险进行分层。
方法
在这项回顾性病例系列研究中，14 年间对 573 例腮腺切除术进行了 376 例术前 FNA。
结果
FNA 的恶性肿瘤风险如下：非诊断性 14.5%，非肿瘤性 26.7%，意义未明的不典型性 29.3%，良性肿瘤 2.7%，不确定恶性潜能的肿瘤 19.1%，疑似恶性 87.5%，恶性 100%。FNA 诊断的多形性腺瘤和沃辛瘤的特异性诊断具有很高的阳性预测值，分别为 97.5%和 96.6%。多变量回归分析表明，病变较小与非诊断性或不确定结果相关。术者的资历与非诊断性结果的可能性降低相关。
结论
这项大型亚洲系列研究验证了米兰系统是对腮腺 FNA 的恶性肿瘤风险进行分层的有用工具。
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