《米兰系统报告唾液腺细胞病理学：细胞组织学一致性和恶性风险评估》。
The Milan System for Reporting Salivary Gland Cytopathology: Assessment of Cytohistological Concordance and Risk of Malignancy.
机构信息
Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, India.
Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, India,
出版信息
Acta Cytol. 2021;65(1):27-39. doi: 10.1159/000510720. Epub 2020 Oct 12.
INTRODUCTION
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was proposed by the American Society of Cytopathology and the International Academy of Cytology to bring uniformity in the reporting system and the treatment protocol. A wide range of risk of malignancy for each category has been reported by various authors by applying the system.
AIM
We intend to study the cytohistological concordance and the ROM for each of the diagnostic categories of the Milan system.
MATERIALS AND METHODS
The study included 292 cases of fine-needle aspiration cytology (FNAC) of salivary gland lesions over a period of 3 years. The diagnosis of these cases was reclassified into the 6 categories of the Milan system. The cytohistological concordance and ROM for each category of the Milan system were calculated based on the clinical and histopathological follow-up.
RESULTS
The patients' age ranged from 3 to 81 years with the mean of 42.65 ± 16.3 years. The cases included 189 (64.7%) parotid, 82 (28.1%) submandibular, and 21 (7.2%) cases of minor salivary gland swellings. Follow-up histopathological diagnosis for 102 cases was available. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated to be 64.28, 97.01, 90, 86.67, and 87.37%, respectively. After reclassification, the number of cases in each category was as follows: category I: 31 (10.62%), category II: 80 (27.4%), category III: 2 (0.68%), category IVA: 143 (48.97%), category IVB: 1 (0.34%), category V: 13 (4.45%), and category VI: 22 (7.53%). The calculated ROM was as follows: category I: 42.86%, category II: 26.67%, category III: 100% category IVA: 10.17%, category IVB: 0%, category V: 71.42%, category VI: 100%.
CONCLUSION
FNAC is an excellent procedure to differentiate benign from malignant tumors, and MSRSGC is a useful system for risk assessment and deciding the further treatment protocol. Our findings also suggest that in addition to the surgical follow-up, inclusion of the clinical and radiological follow-up may be a better strategy for calculation of ROM, especially for categories I and II.
简介
米兰唾液腺细胞病理学报告系统（MSRSGC）由美国细胞病理学学会和国际细胞学学会提出，旨在使报告系统和治疗方案标准化。不同作者应用该系统报道了各分类的恶性肿瘤风险程度差异较大。
目的
我们旨在研究米兰系统各诊断类别的细胞组织学一致性和恶性肿瘤风险程度（ROM）。
材料与方法
本研究纳入了 3 年内 292 例唾液腺细针穿刺细胞学（FNAC）病例。这些病例的诊断根据米兰系统的 6 个类别进行重新分类。根据临床和组织病理学随访，计算每个米兰系统类别的细胞组织学一致性和 ROM。
结果
患者年龄 3-81 岁，平均 42.65±16.3 岁。病例包括 189 例（64.7%）腮腺、82 例（28.1%）下颌下腺和 21 例（7.2%）小唾液腺肿块。102 例获得了组织病理学随访。计算得出的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 64.28%、97.01%、90%、86.67%和 87.37%。重新分类后，每个类别的病例数如下：I 类：31 例（10.62%）、II 类：80 例（27.4%）、III 类：2 例（0.68%）、IVA 类：143 例（48.97%）、IVB 类：1 例（0.34%）、V 类：13 例（4.45%）和 VI 类：22 例（7.53%）。计算得出的 ROM 如下：I 类：42.86%、II 类：26.67%、III 类：100%、IVA 类：10.17%、IVB 类：0%、V 类：71.42%、VI 类：100%。
结论
FNAC 是一种区分良性和恶性肿瘤的优秀方法，MSRSGC 是一种用于风险评估和决定进一步治疗方案的有用系统。我们的研究结果还表明，除了手术随访外，包括临床和影像学随访可能是计算 ROM 的更好策略，尤其是对于 I 类和 II 类。
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