Alwagdani Ashwag, Alhejaili Mohammad, Alanzi Abdulaziz, Alghamdi Saif
Department of Otolaryngology-Head and Neck Surgery, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
Department of Otolaryngology-Head and Neck Surgery, Prince Sultan Armed Forces Hospital, Madina, Saudi Arabia.
Ann Med Surg (Lond). 2021 Mar 15;64:102229. doi: 10.1016/j.amsu.2021.102229. eCollection 2021 Apr.
Parotid gland tumors are mostly benign with good prognosis. On the other hand, malignant tumors of the parotid gland often have poor prognosis and metastasize. Mucoepidermoid carcinoma is the most common cancer in the parotid gland accounting for nearly 40-50% of the cases. Therefore, it is important to define the role of fine needle aspiration in differentiating between different types of parotid malignancies.
This is a retrospective chart review study that was done on 49 consecutive patients who underwent parotid surgeries in King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia, between Jan 2003 and Feb 2020. The records of 49 patients were obtained, fine needle aspiration and pathology reports were reviewed to define the role of fine needle aspiration in diagnosing malignant parotid tumors by calculating the sensitivity, specificity, positive predictive value, and negative predictive value.
Retrospective analysis of 39 cases revealed that there was one case which was diagnosed for cancer was missed by fine needle aspiration. Meanwhile, six cases were diagnosed as malignant lesions using both fine needle aspiration and histopathology. Furthermore, 30 cases were determined benign based on fine needle aspiration and histopathology. The sensitivity of fine needle aspiration for detecting malignancy was 85.7%, specificity was 93.8%. positive predictive value of 75% and negative predictive value of 96.7%.
Fine needle aspiration is highly sensitive and specific for parotid tumors. We support the role of pre-operative FNA for all parotid tumors as its accurate in differentiating between benign and malignant lesions.
腮腺肿瘤大多为良性,预后良好。另一方面,腮腺恶性肿瘤预后往往较差且会发生转移。黏液表皮样癌是腮腺中最常见的癌症,占病例的近40%-50%。因此,明确细针穿刺在鉴别不同类型腮腺恶性肿瘤中的作用很重要。
这是一项回顾性病历审查研究,对2003年1月至2020年2月期间在沙特阿拉伯吉达法赫德国王武装部队医院接受腮腺手术的49例连续患者进行。获取49例患者的记录,审查细针穿刺和病理报告,通过计算敏感性、特异性、阳性预测值和阴性预测值来确定细针穿刺在诊断腮腺恶性肿瘤中的作用。
对39例病例的回顾性分析显示,有1例经细针穿刺漏诊为癌症。同时,有6例经细针穿刺和组织病理学检查均诊断为恶性病变。此外,30例根据细针穿刺和组织病理学检查确定为良性。细针穿刺检测恶性肿瘤的敏感性为85.7%,特异性为93.8%,阳性预测值为75%,阴性预测值为96.7%。
细针穿刺对腮腺肿瘤具有高度敏感性和特异性。我们支持对所有腮腺肿瘤进行术前细针穿刺抽吸,因为它在区分良性和恶性病变方面很准确。