米兰标准是否影响管理？米兰标准分类中切除术率和手术时间的回顾性分析。
Does Milan affect management? A retrospective analysis of resection rate and time to surgery among Milan categories.
机构信息
Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia, USA.
Winship Cancer Center, Decatur, Georgia, USA.
出版信息
Diagn Cytopathol. 2023 Apr;51(4):221-229. doi: 10.1002/dc.25104. Epub 2023 Jan 26.
INTRODUCTION
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is an established system with reproducible risk of malignancies (ROM) for salivary gland fine needle aspiration (SGFNA). No studies have reviewed the relationship between Milan categories and the resection rate (RR) and time to resection (TTR).
METHODS
We searched our database (January 1, 2011 to January 4, 2021) for non-lymphoma SGFNAs and assigned appropriate MSRSGC categories. RR and TTR were calculated and compared for each category. A literature search was performed; RRs and TTRs were compared.
RESULTS
Seven hundred and eighty SGFNAs were identified, 333 with follow-up. RR was highest in suspicious for malignancy (SUS, V; 70.6%, n = 12/17), followed by the salivary gland neoplasm of uncertain malignant potential (SUMP, IVb; 69.6%, n = 80/115) and malignant (M, VI; 55.6%, n = 75/135). Among M, primary tumors had a higher RR (65.1%, n = 41/63) than metastases (47.2%, n = 34/72, p = .36). In literature review, SUS had the highest RR (69.3%, n = 233/336) followed by M (61.6%, n = 821/1332) and SUMP (60.2%, n = 632/1050). TTR was shorter in SUS (mean = 32.3 days, median = 25 days). Within the benign neoplasms (BN, IVa), Pleomorphic adenomas (PAs) had a higher RR than Warthin tumors (WTs) (66.3% vs. 37.2%, p < .00001), and a shorter TTR (median = 63 days vs. 90 days).
CONCLUSIONS
Tumors classified as SUS had higher RR and at shorter intervals than those classified as SUMP. PAs have higher RRs and more expedient surgery than WTs. Cases classified as M are less likely to undergo follow-up than SUS, perhaps due to a lower RR for metastases.
简介
米兰唾液腺细胞病理学报告系统（MSRSGC）是一种经过验证的系统，具有可重复的恶性肿瘤风险（ROM）用于唾液腺细针抽吸（SGFNA）。目前尚无研究探讨米兰分类与切除率（RR）和切除时间（TTR）之间的关系。
方法
我们检索了我们的数据库（2011 年 1 月 1 日至 2021 年 1 月 4 日），其中包括非淋巴瘤 SGFNAs，并分配了适当的 MSRSGC 类别。计算并比较了每个类别的 RR 和 TTR。进行了文献检索；比较 RR 和 TTR。
结果
共确定了 780 例 SGFNAs，其中 333 例有随访。可疑恶性肿瘤（SUS，V）的 RR 最高（70.6%，n=12/17），其次是唾液腺低度恶性肿瘤（SUMP，IVb；69.6%，n=80/115）和恶性肿瘤（M，VI；55.6%，n=75/135）。在 M 中，原发肿瘤的 RR 高于转移瘤（65.1%，n=41/63），转移瘤的 RR 为 47.2%（n=34/72，p=0.36）。文献复习中，SUS 的 RR 最高（69.3%，n=233/336），其次是 M（61.6%，n=821/1332）和 SUMP（60.2%，n=632/1050）。SUS 的 TTR 更短（平均=32.3 天，中位数=25 天）。在良性肿瘤（BN，IVa）中，多形性腺瘤（PA）的 RR 高于沃辛瘤（WT）（66.3% vs. 37.2%，p<0.00001），TTR 更短（中位数=63 天 vs. 90 天）。
结论
分类为 SUS 的肿瘤 RR 高于 SUMP ，间隔时间更短。PA 的 RR 高于 WT，手术时间更短。分类为 M 的病例比 SUS 更不可能接受随访，可能是因为转移瘤的 RR 较低。
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