Dept of Otorhinolaryngology, University of Medical Sciences, Bagcilar Training and Research Hospital, Merkez Mahallesi, 6. Sk. Bağcilar, 34100, Istanbul, Turkey.
Dept of Otorhinolaryngology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2021 Oct;278(10):4067-4074. doi: 10.1007/s00405-021-07022-x. Epub 2021 Jul 31.
Fine needle aspiration (FNA) and core needle biopsy (CNB) are two commonly used approaches for the diagnosis of suspected neoplastic parotid gland lesions. We aimed to compare the diagnostic efficiency of FNA and CNB performed with ultrasound guidance preoperatively for the diagnosis of parotid neoplasms.
We retrospectively analysed the preoperative specimens of 113 patients (66 FNA, 47 CNB) who underwent surgical excision at our institute between 2014 and 2017. Patient selection was based on lesion type and dimension, preliminary and final pathology, imaging characteristics, clinical course, and treatment data for accurate statistical analysis. The final diagnosis was based on surgery in all of the patients. We compared the diagnostic accuracy of FNA and CNB regarding the correct tissue-specific diagnosis of benign and malignant tumours. The recurrence and complication rates were analysed to determine the safety of each technique.
Among the 113 patients, the average follow-up period was 65.4 (50-88) months. Seventy-one patients (62.8%) were males, and the median age was 50 years. The most common type of surgery was superficial parotidectomy (83.2%), and the median tumour size was 30.0 mm. Pleomorphic adenoma was the most frequent neoplasm. The diagnostic rates of preoperative pathological evaluation of FNA and CNB samples were 68.2% and 91.5%, respectively. The sensitivity, specificity, and positive predictive value of FNA for detecting malignant lesions were 40, 100, and 100%, respectively, and those of CNB were 100, 100, and 100%, respectively. Only one complication occurred (haematoma) in the biopsy area after CNB. No recurrences were seen after CNB and FNA during the follow-up period.
Our findings suggest that the diagnostic ability, sensitivity, and specificity of CNB are excellent compared with those of FNA. The only disadvantage of CNB is the need for experienced staff and good-quality equipment. The complication rates of each technique are very low, and the risk of tumour tract seeding is controversial. CNB should be considered the technique of choice when a nodule is detected in the parotid glands.
细针抽吸（FNA）和核心针活检（CNB）是两种常用于诊断疑似肿瘤性腮腺病变的方法。我们旨在比较术前超声引导下 FNA 和 CNB 对腮腺肿瘤的诊断效率。
我们回顾性分析了 2014 年至 2017 年间在我院接受手术切除的 113 例患者（66 例 FNA，47 例 CNB）的术前标本。根据病变类型和大小、初步和最终病理、影像学特征、临床过程和治疗数据进行患者选择，以便进行准确的统计分析。所有患者均基于手术进行最终诊断。我们比较了 FNA 和 CNB 在良性和恶性肿瘤的正确组织特异性诊断方面的诊断准确性。分析了复发和并发症发生率，以确定每种技术的安全性。
在 113 例患者中，平均随访时间为 65.4（50-88）个月。71 例（62.8%）为男性，中位年龄为 50 岁。最常见的手术类型为腮腺浅叶切除术（83.2%），中位肿瘤大小为 30.0mm。多形性腺瘤是最常见的肿瘤。FNA 和 CNB 术前病理评估的诊断率分别为 68.2%和 91.5%。FNA 检测恶性病变的敏感性、特异性和阳性预测值分别为 40%、100%和 100%，CNB 分别为 100%、100%和 100%。CNB 后仅在活检区域出现 1 例并发症（血肿）。在随访期间，CNB 和 FNA 均未出现复发。
我们的研究结果表明，与 FNA 相比，CNB 的诊断能力、敏感性和特异性均非常出色。CNB 的唯一缺点是需要有经验的工作人员和高质量的设备。每种技术的并发症发生率都非常低，而肿瘤播散的风险则存在争议。当在腮腺中发现结节时，应考虑 CNB 作为首选技术。
