Khan Lubna, Sudarsini Saheeta, Mishra Vandana, Dwivedi Shobha, Kala Chayanika
Department of Pathology, GSVM Medical College, Kanpur, Uttar Pradesh, India.
Diagn Cytopathol. 2022 Jun;50(6):295-299. doi: 10.1002/dc.24951. Epub 2022 Mar 14.
Interpretation of salivary gland cytology often leads to inter-observer variability due to heterogenous and complex nature of these lesions. This creates a dilemma regarding their management by clinicians. Proposal of a universal system of reporting of salivary gland lesions leading to agreement in diagnosis and better understanding among clinicians was the need of the hour. Hence Milan system for reporting salivary gland cytopathology (MSRSGC) was proposed in 2015 by the American society of cytopathology and the International Academy of Cytology. Present study was undertaken to assess inter-observer variability in reporting by conventional system and MSRSGC.
One hundred and seventy-six cases of salivary gland lesions were subjected to fine needle aspiration cytology. Cases were interpreted by two experienced cytopathologists and were reported by both conventional system and MSRSGC. Histopathological correlation was available in 81 cases.
Inter-observer variability was noted in six cases reported by conventional system and in two cases by MSRSGC. Moreover three cases out six cases had different management protocols while both cases of Milan system for reporting salivary gland cytology had same management. Thirteen cases diagnosed by Milan system and 17 cases diagnosed by conventional system were discordant with histopathological diagnosis.
Milan system for reporting salivary gland cytology has an edge over conventional system of reporting as it provides better agreement among cytopathologists and better management guidelines for clinicians with the added advantage of assessment of risk of malignancy.
由于唾液腺病变具有异质性和复杂性，唾液腺细胞学的解读常常导致观察者间的差异。这给临床医生对其进行管理带来了困境。当时迫切需要提出一个通用的唾液腺病变报告系统，以达成诊断上的共识并增进临床医生之间的理解。因此，美国细胞病理学学会和国际细胞学会于2015年提出了米兰唾液腺细胞病理学报告系统（MSRSGC）。本研究旨在评估传统系统和MSRSGC报告中的观察者间差异。
对176例唾液腺病变进行细针穿刺细胞学检查。由两位经验丰富的细胞病理学家对病例进行解读，并分别按照传统系统和MSRSGC进行报告。81例病例有组织病理学对照。
在按照传统系统报告的6例病例以及按照MSRSGC报告的2例病例中发现了观察者间差异。此外，在传统系统报告的6例病例中有3例有不同的管理方案，而米兰唾液腺细胞学报告系统的2例病例有相同的管理方案。按照米兰系统诊断的13例病例和按照传统系统诊断的17例病例与组织病理学诊断不一致。
米兰唾液腺细胞学报告系统比传统报告系统更具优势，因为它在细胞病理学家之间提供了更好的一致性，为临床医生提供了更好的管理指南，并且具有评估恶性风险的额外优势。
