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涎腺病变的细针穿刺细胞学检查:基于“米兰系统”的修订分类——印度南部三级护理癌症中心的4年经验

Fine-Needle Aspiration Cytology of Salivary Gland Lesions: A Revised Classification Based on "Milan System"-4years Experience of Tertiary Care Cancer Center of South India.

作者信息

Mukundapai Malathi, Sharma Neelam, Patil Akkamahadevi, Gopal Champaka

机构信息

Cytology and Histopathology Division, Kidwai Cancer Center, Bangalore, Karnataka, India.

出版信息

J Cytol. 2020 Jan-Mar;37(1):12-17. doi: 10.4103/JOC.JOC_68_18. Epub 2019 Dec 23.

Abstract

BACKGROUND

Fine-needle aspiration cytology plays role in preoperative diagnosis of any salivary gland mass lesions. Because of heterogeneity of salivary gland lesions and cytomorphology overlap, a uniform 6-tier Milan classification proposed which could be helpful in better communication of reports for patient's management.

METHODS

Study included 4 years (2011-2015) retrospective data retrieval from cytology department of our Institute, which is a tertiary care cancer center of South India. Histopathology correlation was done wherever possible.

RESULT

Total 253 cases were studied. Histopathological follow-up was available in 115 cases. Cases were categorized as nondiagnostic (1.58%), nonneoplastic (13.43%), benign (30%), atypia (0.8%), and suspicious for malignancy and malignant cytology (51.8%). The risk for malignancy was high for suspicious for malignancy and malignant cytological categories ranged from 96-100%. The sensitivity, specificity, and accuracy for diagnosing malignancy varied from 86.76%, 93.75%, and 89%, respectively.

CONCLUSION

Risk stratification approach in classifying salivary gland cytology aspirate as per Milan system provides a standardized reporting and better communication to clinician.

摘要

背景

细针穿刺细胞学检查在任何唾液腺肿块病变的术前诊断中发挥作用。由于唾液腺病变的异质性和细胞形态学重叠,提出了统一的6级米兰分类法,这有助于在报告中更好地沟通,以利于患者的管理。

方法

本研究纳入了印度南部一家三级癌症中心我院细胞学部门4年(2011 - 2015年)的回顾性数据检索。尽可能进行组织病理学相关性分析。

结果

共研究了253例病例。115例有组织病理学随访结果。病例分为非诊断性(1.58%)、非肿瘤性(13.43%)、良性(30%)、非典型性(0.8%)以及恶性可疑和恶性细胞学(51.8%)。恶性可疑和恶性细胞学分类的恶性风险很高,范围为96 - 100%。诊断恶性肿瘤的敏感性、特异性和准确性分别为86.76%、93.75%和89%。

结论

根据米兰系统对唾液腺细胞学吸出物进行风险分层的方法提供了标准化报告,并能更好地与临床医生沟通。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85dc/6947727/a548224c336f/JCytol-37-12-g001.jpg

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