Department of Pathology, Seth Gordhandas Sunderdas Medical College and KEM Hospital, Mumbai, India.
Department of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.
Diagn Cytopathol. 2021 Apr;49(4):500-508. doi: 10.1002/dc.24697. Epub 2021 Jan 14.
Fine-needle aspiration cytology (FNAC) is an established technique for preoperative diagnosis of salivary gland lesions; however, lack of a uniform reporting system has been a handicap. The main aims of this study were to evaluate the utility of the - "The Milan System for Reporting Salivary Gland Cytopathology" (MSRSGC) and ascertain the risk of malignancy (ROM) for each category.
All salivary gland FNACs over 5 years (January 2014-December 2018) were reviewed and assigned a diagnostic category from the MSRSGC. Clinical data were taken from Cytology records. Cytodiagnosis was correlated with histopathology wherever available and ROM was calculated.
A total of 120 salivary gland FNACs were studied. Age ranged between 5 and 85 years, male:female ratio was 2:1 and parotid was the commonest gland aspirated. Cases were reclassified as I non-diagnostic (2.5%), II non-neoplastic (15%), III atypia of uncertain significance-AUS (1.7%), IV A neoplasm benign (50%), IV B neoplasm of uncertain malignant potential (12.5%), V suspicious for malignancy (5%), and VI malignant (13.3%). Follow-up was available in 70 (58.3%) cases. The sensitivity, specificity, negative predictive value, and positive predictive value were 92.3%, 100%, 100%, and 98.27% respectively. ROM was non-neoplastic (0%), AUS (50%), neoplasm benign (0%), neoplasm of uncertain malignant potential (28.6%), suspicious for malignancy (100%), and malignant (100%).
Salivary gland FNAC is a reliable diagnostic tool and the "Milan system" will further increase FNA reliability, help risk stratification, and improve patient care.
细针吸取细胞学（FNAC）是术前诊断唾液腺病变的成熟技术；然而，缺乏统一的报告系统一直是一个障碍。本研究的主要目的是评估“米兰唾液腺细胞病理学报告系统”（MSRSGC）的实用性，并确定每个类别中的恶性肿瘤风险（ROM）。
回顾了过去 5 年（2014 年 1 月至 2018 年 12 月）的所有唾液腺 FNAC，并根据 MSRSGC 分配了诊断类别。临床数据取自细胞学记录。在有条件的情况下，将细胞学诊断与组织病理学相关联，并计算 ROM。
共研究了 120 例唾液腺 FNAC。年龄在 5 至 85 岁之间，男女比例为 2:1，最常见的是腮腺抽吸。病例被重新分类为 I 未诊断（2.5%）、II 非肿瘤性（15%）、III 意义不明的非典型性-AUS（1.7%）、IV A 良性肿瘤（50%）、IV B 恶性潜能不明的肿瘤（12.5%）、V 疑似恶性肿瘤（5%）和 VI 恶性肿瘤（13.3%）。70 例（58.3%）有随访。敏感性、特异性、阴性预测值和阳性预测值分别为 92.3%、100%、100%和 98.27%。ROM 为非肿瘤性（0%）、AUS（50%）、良性肿瘤（0%）、恶性潜能不明的肿瘤（28.6%）、疑似恶性肿瘤（100%）和恶性肿瘤（100%）。
唾液腺 FNAC 是一种可靠的诊断工具，“米兰系统”将进一步提高 FNA 的可靠性，帮助风险分层，改善患者护理。
