Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Cancer Cytopathol. 2022 Nov;130(11):849-859. doi: 10.1002/cncy.22604. Epub 2022 May 30.
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a standard, evidence-based classification system for salivary gland fine-needle aspiration (SG-FNA). Since it was published in 2018, many researchers across the world have applied this uniform reporting system to their cohorts.
The authors comprehensively reviewed cohort studies conducted since publication of the MSRSGC and performed a meta-analysis. The risk of neoplasm and the risk of malignancy (ROM) were calculated for each diagnostic category, and their diagnostic efficacy was evaluated.
Thirty-five studies were included in the meta-analysis. The total number of SG-FNAs was 10,706, and 7168 of those had histopathologic follow-up. The ROM for each category was: nondiagnostic, 11.4%; nonneoplastic, 10.9%; atypia of undetermined significance, 30.5%; neoplasm-benign, 2.8%; neoplasm-salivary gland neoplasm of uncertain malignant potential, 37.7%; suspicious for malignancy, 83.8%; and malignant, 97.7%. Low-level heterogeneity was observed in ROM estimation. The sensitivity, specificity, and diagnostic odds ratio for differentiating malignant and benign lesions were 88.0%, 98.5% and 520.3, respectively.
The reporting of SG-FNA using the MSRSGC demonstrated high diagnostic accuracy. The ROM for each category was generally concordant with the recommendations, except for the suspicious for malignancy category, which was significantly higher than the reference value. The tiered, standardized classification system would benefit the clinical management of salivary gland lesions.
米兰唾液腺细胞病理学报告系统（MSRSGC）是一种用于唾液腺细针抽吸（SG-FNA）的标准、基于证据的分类系统。自 2018 年发布以来，世界各地的许多研究人员都将这一统一的报告系统应用于他们的队列。
作者全面回顾了自 MSRSGC 发布以来开展的队列研究，并进行了荟萃分析。计算了每个诊断类别中的肿瘤风险和恶性风险（ROM），并评估了其诊断效能。
共有 35 项研究纳入荟萃分析。SG-FNA 的总数为 10706 例，其中 7168 例有组织病理学随访。每个类别的 ROM 分别为：非诊断性，11.4%；非肿瘤性，10.9%；意义未确定的非典型性，30.5%；良性肿瘤，2.8%；唾液腺肿瘤低度恶性潜能肿瘤，37.7%；疑似恶性，83.8%；恶性，97.7%。在 ROM 估计中观察到低水平的异质性。鉴别良恶性病变的敏感性、特异性和诊断优势比分别为 88.0%、98.5%和 520.3。
使用 MSRSGC 报告 SG-FNA 具有较高的诊断准确性。除了疑似恶性类别，其 ROM 与建议值大致相符，而疑似恶性类别显著高于参考值。分层、标准化的分类系统将有利于唾液腺病变的临床管理。
