Davidoff Cancer Center, Institute of Oncology, Rabin Medical Center - Beilinson Hospital, Petach Tikva 4941492, Israel.
Davidoff Cancer Center, Institute of Oncology, Rabin Medical Center - Beilinson Hospital, Petach Tikva 4941492, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Am J Otolaryngol. 2020 Jan-Feb;41(1):102293. doi: 10.1016/j.amjoto.2019.102293. Epub 2019 Sep 10.
To assess the clinical value of ultrasound (US) and fine needle aspiration (FNA) of salivary gland lesions prior to surgery, for preoperative decision-making and long-term follow-up/outcome.
MATERIALS & METHODS: We retrospectively analyzed the medical charts of 98 consecutive patients with major salivary gland lesions who were treated in a single medical from 2008 to 2017. Preoperative US and FNA was performed in all patients. Cytology results were compared with histopathological diagnoses. The correlation between preoperative US findings, cytology and histopathological diagnoses was assessed.
Twenty-three specimens were histopathologically malignant, and 75 were diagnosed as benign. Three false-positive results diagnosed as malignant in cytology had a final histology of sialadenitis, pleomorphic adenoma and Warthin's tumor, respectively. In six cases, cytology yielded false-negative results. The overall accuracy of FNA in distinguishing benign from malignant lesions was 91%. Sensitivity was 70% and specificity 93%. There was no significant correlation between US features and final pathology, but larger size had some correlation with malignancy (p = 0.306). No complications were observed during or after performing FNA.
FNA from salivary gland lesions is safe and in many cases can help in preoperative decision making or surgical planning. Hence, the results of FNA cytology should have an integral role in clinical decision-making and management of major salivary gland lesions. False-negative results do occur and therefore should be used only as an adjunctive measure.
评估术前唾液腺病变的超声（US）和细针抽吸（FNA）在术前决策和长期随访/结果方面的临床价值。
我们回顾性分析了 2008 年至 2017 年期间在一家医疗机构接受治疗的 98 例大唾液腺病变患者的病历。所有患者均接受术前 US 和 FNA 检查。细胞学结果与组织病理学诊断进行比较。评估术前 US 结果、细胞学和组织病理学诊断之间的相关性。
23 份标本组织病理学为恶性，75 份诊断为良性。细胞学诊断为恶性的 3 例假阳性结果分别为涎腺炎、多形性腺瘤和沃辛瘤。在 6 例中，细胞学结果为假阴性。FNA 区分良恶性病变的总准确率为 91%。灵敏度为 70%，特异性为 93%。US 特征与最终病理之间无显著相关性，但较大的病变大小与恶性肿瘤有一定相关性（p=0.306）。在进行 FNA 过程中或之后未观察到任何并发症。
对唾液腺病变进行 FNA 是安全的，在许多情况下可以帮助进行术前决策或手术计划。因此，FNA 细胞学结果应在大唾液腺病变的临床决策和管理中发挥重要作用。确实会出现假阴性结果，因此只能作为辅助措施。
