Sideris Giorgos, Margaris Ioannis, Nikolopoulos Thomas, Delides Alexander
Otolaryngology Department, School of Medicine, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
Department of Surgery, School of Medicine, National & Kapodistrian University of Athens, Attikon" University Hospital, Athens, Greece.
Iran J Otorhinolaryngol. 2024;36(6):675-680. doi: 10.22038/ijorl.2024.76596.3565.
This study aimed to investigate the relationship between preoperative fine needle aspiration cytology (FNAC) for parotid tumors and the level of surgical training among residents, as well as to further elucidate its effectiveness as a diagnostic tool in the hands of the treating physician.
Surgical records from patients who underwent parotid surgery between 2014 and 2022 were retrieved. Residents reported their perceived level of training duringthese procedures. Contingency tables were used to correlate the cytological with final histopathological results.
A total of 286 patients who had undergone preoperative FNAC were included in the study. A preoperative diagnosis of pleomorphic adenoma or Wharthin's tumor was significantly associated with higher training scores among surgical residents. In contrast, a diagnosis of malignancy, other benign tumors, or indeterminate cytology was correlated with poor training scores (χ2 = 176.35; df = 2; p-value <0.001, Cramer's V 0.79). FNAC demonstrated a sensitivity of 88% and a specificity of 99.2% for detecting malignancy, with a positive likelihood ratio of 103.8 (95% CI: 26.02-414.34) and a negative likelihood ratio of 0.12 (95% CI: 0.06-0.26).
Our findingssuggest that preoperative cytological diagnoses of parotid tumors with a favorable prognosis, such as Wharthin's tumors, can enhance training and mentorship opportunities provided by senior surgeons. This is particularly significant for academic institutions with residency programs.
本研究旨在调查腮腺肿瘤术前细针穿刺细胞学检查（FNAC）与住院医师手术培训水平之间的关系，并进一步阐明其作为治疗医师手中诊断工具的有效性。
检索了2014年至2022年间接受腮腺手术患者的手术记录。住院医师报告了他们在这些手术过程中的自我感知培训水平。使用列联表将细胞学结果与最终组织病理学结果进行关联。
本研究共纳入286例术前行FNAC检查的患者。术前诊断为多形性腺瘤或沃辛瘤与外科住院医师较高的培训分数显著相关。相比之下，恶性肿瘤、其他良性肿瘤或细胞学结果不确定的诊断与较低的培训分数相关（χ2 = 176.35；自由度 = 2；p值 <0.001，克莱默V值0.79）。FNAC检测恶性肿瘤的敏感性为88%，特异性为99.2%，阳性似然比为103.8（95%可信区间：26.02 - 414.34），阴性似然比为0.12（95%可信区间：0.06 - 0.26）。
我们的研究结果表明，术前对预后良好的腮腺肿瘤进行细胞学诊断，如沃辛瘤，可增加资深外科医生提供的培训和指导机会。这对设有住院医师培训项目的学术机构尤为重要。
