验证涎腺细胞病理学报告的米兰系统和细针抽吸细胞学对颌下腺病变的诊断准确性。
Validation of the Milan System for Reporting Salivary Gland Cytopathology and the diagnostic accuracy of FNA cytology for submandibular gland lesions.
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, Radboudumc, Nijmegen, the Netherlands.
Department of Pathology, Radboudumc, Nijmegen, the Netherlands.
出版信息
Cancer Cytopathol. 2022 Mar;130(3):189-194. doi: 10.1002/cncy.22532. Epub 2021 Nov 30.
BACKGROUND
The Milan System for Salivary Gland Cytopathology (MSRSGC) is a categorical system for salivary gland fine-needle aspiration cytopathology (FNAC) developed to aid clinicians in the management of salivary gland lesions. This classification is widely studied and validated, especially in cohorts that consist of mostly parotid gland lesions. However, only sparse literature describes the use of this classification for submandibular gland lesions in particular.
METHODS
All patients in the Netherlands that underwent a submandibular gland resection between January 1, 2006, and January 1, 2017, with a FNAC before resection were identified with the use of the Dutch Pathology Registry database (PALGA). All FNAC results were retrospectively classified according to the MSRSGC. The risk of malignancy was calculated for all the MSRSGC categories. The sensitivity and specificity of the MSRSGC classification were calculated for submandibular gland FNAC.
RESULTS
A total of 837 patients who underwent 975 FNAC aspirates from the submandibular glands were included in the analysis. Risks of malignancy for each of the MSRSGC categories were 14.4% in nondiagnostic, 4.4% in nonneoplastic, 37.0% in atypia of unknown significance, 3.9% in benign neoplasms, 40.7% in salivary gland neoplasms of unknown malignant potential, 76.2% in suspected malignant, and 91.3% in malignant cytology results. The sensitivity for diagnosing malignant submandibular gland tumors was 71.6% and specificity was 98.4%.
CONCLUSIONS
The results of the present study validate the use of this classification for submandibular gland lesions. Risks of malignancy vary according to the anatomical subsites of the salivary gland lesions.
LAY SUMMARY
The risks of malignancy of the various Milan System for Salivary Gland Cytopathology (MSRSGC) categories vary according to the anatomical subsite of the salivary gland lesion. The proposed management techniques of the MSRSGC are valid for use with submandibular gland lesions.
背景
米兰唾液腺细针抽吸细胞学分类系统（MSRSGC）是一种用于唾液腺细针抽吸细胞学（FNAC）的分类系统，旨在帮助临床医生管理唾液腺病变。该分类系统得到了广泛的研究和验证，特别是在主要由腮腺病变组成的队列中。然而，只有很少的文献描述了该分类系统在颌下腺病变中的具体应用。
方法
使用荷兰病理学登记数据库（PALGA），确定了 2006 年 1 月 1 日至 2017 年 1 月 1 日期间在荷兰接受颌下腺切除术且术前接受 FNAC 的所有患者。所有 FNAC 结果均根据 MSRSGC 进行回顾性分类。计算了所有 MSRSGC 类别中的恶性肿瘤风险。计算了 MSRSGC 分类对颌下腺 FNAC 的敏感性和特异性。
结果
共纳入 837 例患者，共进行了 975 例颌下腺 FNAC 抽吸。MSRSGC 各分类的恶性肿瘤风险分别为：非诊断性为 14.4%，非肿瘤性为 4.4%，意义不明的非典型性为 37.0%，良性肿瘤为 3.9%，唾液腺恶性潜能未确定的肿瘤为 40.7%，可疑恶性为 76.2%，恶性细胞学结果为 91.3%。诊断颌下腺恶性肿瘤的敏感性为 71.6%，特异性为 98.4%。
结论
本研究结果验证了该分类系统在颌下腺病变中的应用。恶性肿瘤的风险因唾液腺病变的解剖部位而异。
简介
MSRSGC 各分类的恶性肿瘤风险因唾液腺病变的解剖部位而异。MSRSGC 提出的管理技术适用于颌下腺病变。
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