细针穿刺活检（FNAB）在腮腺肿块诊断中的作用，重点在于潜在的陷阱。
The role of fine-needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls.
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic.
Department of Pathology and Molecular Medicine, Second Faculty of Medicine, University Hospital Motol, Charles University and Motol University Hospital, Prague, Czech Republic.
出版信息
Eur Arch Otorhinolaryngol. 2020 Jun;277(6):1763-1769. doi: 10.1007/s00405-020-05868-1. Epub 2020 Feb 27.
PURPOSE
The treatment strategy of parotid gland tumours depends mainly on the histopathological type of the lesion. Fine-needle aspiration biopsy (FNAB) is recommended in preoperative diagnostics. The aim of the study was to evaluate the FNAB standing in the diagnostic algorithm of parotid gland lesions and to correlate FNAB results in relation to the definitive histopathological diagnosis.
MATERIAL AND METHODS
The retrospective analyses of 651 examined and consequently surgically treated parotid gland lesions at the Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague between 2006 and 2016 were used. Preoperative cytological results were consequently evaluated in relation to the definitive histopathological diagnosis.
RESULTS
The cohort consisted of 367 women and 284 men (average age 58 years). FNAB was diagnostic in 604 (92.8%) patients and non-diagnostic in 47 (7.2%) patients. The result of FNAB was positive (suspicious for malignant tumour) in 89 (14.7%) patients and negative (benign) in 515 (85.3%) patients. Sensitivity of the examination was 80.00%, specificity was 93.82%, PPV 62.92%, NPV 97.28%, and LR + and LR- were 12.95 and 0.21, respectively, with an accuracy of 92.22%.
CONCLUSION
Our results confirm the significant role of FNAB in the diagnostic algorithm of parotid gland lesions.
目的
腮腺肿瘤的治疗策略主要取决于病变的组织病理学类型。术前诊断推荐使用细针抽吸活检（FNAB）。本研究旨在评估 FNAB 在腮腺病变诊断算法中的地位，并将 FNAB 结果与明确的组织病理学诊断相关联。
材料与方法
回顾性分析了 2006 年至 2016 年期间在布拉格查理大学第一医学院耳鼻喉科和头颈部外科接受检查和随后手术治疗的 651 例腮腺病变患者的资料。随后根据明确的组织病理学诊断评估术前细胞学结果。
结果
该队列包括 367 名女性和 284 名男性（平均年龄 58 岁）。FNAB 在 604 例（92.8%）患者中具有诊断价值，在 47 例（7.2%）患者中无诊断价值。FNAB 的结果在 89 例（14.7%）患者中为阳性（疑似恶性肿瘤），在 515 例（85.3%）患者中为阴性（良性）。该检查的敏感性为 80.00%，特异性为 93.82%，PPV 为 62.92%，NPV 为 97.28%，LR+和 LR-分别为 12.95 和 0.21，准确率为 92.22%。
结论
我们的结果证实了 FNAB 在腮腺病变诊断算法中的重要作用。
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