Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan.
Eur Arch Otorhinolaryngol. 2020 Jul;277(7):2031-2039. doi: 10.1007/s00405-020-05871-6. Epub 2020 Mar 12.
The malignancy of parotid carcinoma varies, and accurate preoperative assessment of malignancy is important for selecting the appropriate treatment. However, the preoperative diagnosis of low/intermediate-grade carcinoma is difficult, and surgery may sometimes be performed without any prior knowledge of malignancy.
The results of fine-needle aspiration cytology (FNA), imaging studies (MRI and US), physical examination, and frozen section biopsy (FSB) were evaluated in 112 patients with low/intermediate-grade parotid carcinoma.
The result of FNA was benign/inadequate specimen in 44.6% of the patients. In addition, the tumor was diagnosed as benign by MRI/US in 21.4% of the patients and 37.5% had no symptoms/signs of malignancy on physical examination. The rate of misdiagnosis as benign decreased when FNA was combined with imaging and physical findings. However, malignancy could not be diagnosed by FNA and FSB in 12.5% of the patients who were only found to have malignant tumors by the final pathological examination.
FNA shows a high misdiagnosis rate of malignancy in patients with low/intermediate-grade cancer. Therefore, it is necessary to carefully evaluate the findings of imaging studies and physical examination, and FSB should be conducted if such findings suggest the possibility of malignancy.
腮腺癌的恶性程度各异，准确的术前恶性评估对于选择合适的治疗方法非常重要。然而，对于低度/中度癌的术前诊断较为困难，有时可能在对恶性肿瘤一无所知的情况下进行手术。
对 112 例低度/中度腮腺癌患者的细针穿刺细胞学检查（FNA）、影像学检查（MRI 和 US）、体格检查和冷冻切片活检（FSB）结果进行评估。
44.6%的患者 FNA 结果为良性/标本不足。此外，21.4%的患者 MRI/US 诊断为良性肿瘤，37.5%的患者体格检查无恶性肿瘤的症状/体征。当 FNA 与影像学和体格检查结果相结合时，良性肿瘤的误诊率降低。然而，在最终病理检查仅发现恶性肿瘤的 12.5%的患者中，FNA 和 FSB 无法诊断恶性肿瘤。
FNA 对低度/中度癌症患者的恶性肿瘤诊断存在较高的误诊率。因此，有必要仔细评估影像学检查和体格检查结果，如果这些结果提示恶性肿瘤的可能性，则应进行 FSB。
