回顾性应用米兰系统报告涎腺细胞病理学：癌症中心的经验。
Retrospective application of the Milan System for reporting salivary gland cytopathology: A Cancer Center experience.
机构信息
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil.
Department of Pathology, A.C. Camargo Cancer Center, São Paulo, Brazil.
出版信息
Diagn Cytopathol. 2020 Sep;48(9):821-826. doi: 10.1002/dc.24464. Epub 2020 May 6.
BACKGROUND
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was recently proposed. Herein, we retrospectively applied this nomenclature system to salivary gland lesions sampled by ultrasound-guided fine-needle aspiration (FNA).
METHODS
All cases of salivary gland FNA with available surgical follow-up, in the period from 2014 to 2017 at our institution were reviewed and reclassified according to one of the six categories of the MSRSGC, blind to the surgical outcome. Overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, as well as risks of neoplasm (RON) and risk of malignancy (ROM) for each of the proposed categories.
RESULTS
There were 104 salivary gland lesions, with a female predominance (57.7%), most cases from the parotid gland (89.4%). Mean age was 53.2 years. Distribution of the specimens according to the Milan System was as follows: 19.2% nondiagnostic (ND), 8.7% non-neoplastic (NN), 9.6% atypia of undetermined significance (AUS), 40.4% benign neoplasm (BN), 14.4% salivary gland neoplasm of uncertain malignant potential (SUMP), 1.9% suspicious for malignancy (SFM), and 5.8% malignant. Sensitivity, specificity, PPV, and NPV using MSRSGC were calculated as 75%, 98.4%, 88.9%, and 95.3%, respectively. RON/ROM for each category were 60%/15% for ND, 44.4%/0% for NN, 90%/40% for AUS, 100%/9.5% for BN, 100%/13.3% for SUMP, 50%/50% for SFM and 100%/100% for malignant.
CONCLUSION
The use of the Milan System proved to be a useful method to predict the risk of neoplasm and malignancy in the sample studied, with high sensitivity and specificity.
背景
最近提出了米兰唾液腺细胞病理学报告系统（MSRSGC）。在此，我们回顾性地将该命名系统应用于超声引导下细针抽吸（FNA）采集的唾液腺病变。
方法
在我们的机构中，回顾性分析了 2014 年至 2017 年间所有有手术随访的唾液腺 FNA 病例，并根据 MSRSGC 的六个类别之一进行重新分类，手术结果为盲法。计算了总灵敏度、特异性、阳性预测值（PPV）和阴性预测值（NPV），以及每个建议类别中的肿瘤风险（RON）和恶性风险（ROM）。
结果
共有 104 个唾液腺病变，女性占优势（57.7%），大多数来自腮腺（89.4%）。平均年龄为 53.2 岁。根据米兰系统对标本的分布如下：非诊断性（ND）19.2%、非肿瘤性（NN）8.7%、意义未确定的不典型性（AUS）9.6%、良性肿瘤（BN）40.4%、唾液腺低度恶性潜能肿瘤（SUMP）14.4%、可疑恶性（SFM）1.9%、恶性肿瘤（malignant）5.8%。使用 MSRSGC 计算的灵敏度、特异性、PPV 和 NPV 分别为 75%、98.4%、88.9%和 95.3%。每个类别的 RON/ROM 分别为 ND 为 60%/15%、NN 为 44.4%/0%、AUS 为 90%/40%、BN 为 100%/9.5%、SUMP 为 100%/13.3%、SFM 为 50%/50%和恶性肿瘤为 100%/100%。
结论
使用米兰系统被证明是一种预测研究样本中肿瘤和恶性风险的有用方法，具有较高的灵敏度和特异性。
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