Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea.
Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
Head Face Med. 2024 Oct 26;20(1):64. doi: 10.1186/s13005-024-00467-5.
Preoperative imaging, particularly with magnetic resonance imaging (MRI) and computed tomography (CT) scans, plays a crucial role in distinguishing between benign and malignant parotid gland tumors, while the reliability of Ultrasound-Guided Fine Needle Aspiration (FNA) in diagnosing these masses remains a topic of debate.
This two-center retrospective analysis was conducted on 347 patients with parotid gland tumors who had FNA and preoperative imaging (CT or MRI). All patients underwent surgery and final histopathological examination was available, along with complete medical records between January 2008 and May 2023.
Among the 347 patients, 318 (92%) had benign and 10 (3%) had malignant tumors based on FNA, with 19 (5%) unsatisfactory specimens. Final histological diagnosis revealed 303 (87%) benign and 44 (13%) malignant lesions, with a false-negative rate of 10.6% for FNA. Multivariate analysis identified irregular shape and invasion as independent predictors of malignancy in patient with benign or unsatisfactory FNA results. The odds ratio for irregular shape was 3.06 and for invasion was 12.73.
Imaging characteristics, such as irregular shape and invasion may indicate towards malignant parotid tumors, even in patients with false-negative benign findings in FNA.
术前影像学检查，特别是磁共振成像（MRI）和计算机断层扫描（CT），在区分腮腺良恶性肿瘤方面起着至关重要的作用，而超声引导下细针抽吸（FNA）在诊断这些肿块的可靠性仍然存在争议。
这是一项在 347 名接受 FNA 和术前影像学（CT 或 MRI）检查的腮腺肿瘤患者中进行的两中心回顾性分析。所有患者均接受了手术，且可获得最终的组织病理学检查结果，以及 2008 年 1 月至 2023 年 5 月期间完整的病历记录。
根据 FNA 结果，347 名患者中 318 名（92%）为良性肿瘤，10 名（3%）为恶性肿瘤，19 名（5%）标本不满意。最终组织学诊断显示 303 名（87%）为良性病变，44 名（13%）为恶性病变，FNA 的假阴性率为 10.6%。多变量分析确定不规则形状和侵犯是 FNA 良性或不满意结果患者恶性肿瘤的独立预测因素。不规则形状的优势比为 3.06，侵犯的优势比为 12.73。
即使在 FNA 良性结果为假阴性的患者中，影像学特征（如不规则形状和侵犯）也可能提示为恶性腮腺肿瘤。
