Department of Pathology, New York University Langone Health, New York, NY, USA.
Am J Clin Pathol. 2022 Nov 3;158(5):583-597. doi: 10.1093/ajcp/aqac075.
Our study assesses whether the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) offers any benefit over the original cytology classification, and measures interobserver agreement.
Four cytopathologists retrospectively blindly classified preoperative cytology by MSRSGC from 101 resected salivary tumors. Consensus MSRSGC diagnoses were correlated with surgical pathology diagnoses and compared with the original cytology classification. Diagnostic parameters were calculated for both systems. Interobserver variability was assessed.
The original cytology classification vs MSRSGC had sensitivity, specificity, positive predictive value, and negative predictive value of 75.0% vs 78.3%, 97.1% vs 98.0%, 91.2% vs 94.7%, and 90.1% vs 90.0%, respectively. The original cytology classification risk of neoplasm (RON) was 91.7% for "negative for malignancy" and 100.0% for other categories. The MSRSGC RON was 71.4% in category II (nonneoplastic) and 100.0% in all other categories. The original cytology classification risk of malignancy (ROM) ranged from 0.0% for "atypical" to 100.0% for "positive for malignancy." The MSRSGC ROM ranged from 0.0% in categories I (nondiagnostic) and III (nonneoplastic) to 100.0% in category VI (malignant). Weighted agreement using the MSRSGC was 92% (Gwet AC1, 0.84); unweighted agreement was 69% (Gwet AC1, 0.64). MSRSGC category IVA (benign neoplasm) was most likely to show interobserver agreement, with complete agreement in 67% of cases.
The MSRSGC performs similarly to the original cytology classification and shows relatively high interobserver agreement.
本研究评估了米兰唾液腺细胞病理学报告系统（MSRSGC）是否优于原始细胞学分类，并衡量了观察者间的一致性。
4 位细胞病理学家回顾性地对 101 例切除的唾液腺肿瘤的术前细胞学进行盲法分类，按照 MSRSGC 进行分类。将共识性 MSRSGC 诊断与手术病理诊断进行相关性分析，并与原始细胞学分类进行比较。对两个系统的诊断参数进行了计算。评估了观察者间的变异性。
原始细胞学分类与 MSRSGC 的敏感性、特异性、阳性预测值和阴性预测值分别为 75.0%与 78.3%、97.1%与 98.0%、91.2%与 94.7%和 90.1%与 90.0%。原始细胞学分类的肿瘤风险（RON）对于“恶性阴性”为 91.7%，而对于其他类别为 100.0%。MSRSGC 的 RON 在 II 类（非肿瘤性）为 71.4%，在所有其他类别为 100.0%。原始细胞学分类的恶性风险（ROM）从“非典型”的 0.0%到“恶性阳性”的 100.0%不等。MSRSGC 的 ROM 从 I 类（无诊断意义）和 III 类（非肿瘤性）的 0.0%到 VI 类（恶性）的 100.0%不等。使用 MSRSGC 的加权一致性为 92%（Gwet AC1，0.84）；未加权一致性为 69%（Gwet AC1，0.64）。MSRSGC 类别 IVA（良性肿瘤）最有可能显示观察者间的一致性，其中 67%的病例完全一致。
MSRSGC 的表现与原始细胞学分类相似，并且显示出相对较高的观察者间一致性。
