腮腺肿瘤的术前评估与治疗考量
Preoperative evaluation and treatment consideration of parotid gland tumors.
作者信息
Aro Katri, Korpi Jarkko, Tarkkanen Jussi, Mäkitie Antti, Atula Timo
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery University of Helsinki and Helsinki University Hospital Helsinki Finland.
Department of Pathology HUSLAB, University of Helsinki and Helsinki University Hospital Helsinki Finland.
出版信息
Laryngoscope Investig Otolaryngol. 2020 Jul 20;5(4):694-702. doi: 10.1002/lio2.433. eCollection 2020 Aug.
BACKGROUND
The nature of parotid tumors often remains unknown preoperatively and final histopathology may reveal unexpected malignancy. Still, the use of fine-needle aspiration cytology (FNAC) and imaging varies in the management of these tumors.
METHODS
We evaluated the preoperative examinations and management of all 195 parotid gland tumors diagnosed within our catchment area of 1.6 million people during 2015.
RESULTS
Altogether 171 (88%) tumors were classified as true salivary gland neoplasms. FNAC showed no false malignant findings, but it was false benign in 5 (2.6%) cases. Preoperative MRI was utilized in 48 patients (25%). Twenty (10%) malignancies included 16 salivary gland carcinomas. Pleomorphic adenomas accounted for 52% of all adenomas. For 24 (40%) Warthin tumors, surgery was omitted.
CONCLUSION
The proportion of malignancies was lower than generally presented. Our proposed guidelines include ultrasound-guided FNAC with certain limitations. MRI is warranted in selected cases, but seems unnecessary routinely.
背景
腮腺肿瘤的性质在术前往往不明，最终的组织病理学检查可能会揭示出意想不到的恶性情况。尽管如此，细针穿刺抽吸细胞学检查（FNAC）和影像学检查在这些肿瘤的治疗中应用各异。
方法
我们评估了2015年在我们160万人口的服务区域内诊断出的所有195例腮腺肿瘤的术前检查和治疗情况。
结果
总共171例（88%）肿瘤被归类为真正的涎腺肿瘤。FNAC未出现假阳性恶性结果，但有5例（2.6%）为假阴性良性结果。48例患者（25%）进行了术前MRI检查。20例（10%）恶性肿瘤包括16例涎腺癌。多形性腺瘤占所有腺瘤的52%。对于24例（40%）沃辛瘤，未进行手术。
结论
恶性肿瘤的比例低于一般报道。我们提出的指南包括有一定局限性的超声引导下FNAC。在特定病例中进行MRI检查是必要的，但常规情况下似乎没有必要。
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