B M Nandakumar, S Sandeep, H V Madhukumar, Hiremath Srikantaiah C, Priya Padma
General Surgery, Ramaiah Medical College, Bengaluru, IND.
General Surgery, Indira Gandhi Medical College and Hospital, Shimla, IND.
Cureus. 2025 Jun 16;17(6):e86177. doi: 10.7759/cureus.86177. eCollection 2025 Jun.
Background Parotid gland swellings are the most common salivary gland lesions. Fine-Needle Aspiration Cytology (FNAC), apart from being the first-line diagnostic tool in the evaluation of parotid gland swellings, plays an integral role in planning both surgical and non-surgical therapy. Objectives To determine the diagnostic accuracy of FNAC in the evaluation of parotid gland swellings. Methodology Medical records of all patients who underwent surgery for parotid gland lesions at Ramaiah Medical College and Hospital, Bengaluru, Karnataka, since 2010 were retrospectively analyzed. Demographic data, FNAC reports, and final histopathology reports were extracted, assessed, and statistically analyzed. Results Out of the 193 patients who underwent surgery for parotid gland swelling during the study period, 112 cases were included in the study. The cohort consisted of 67 male and 45 female patients, with a mean age of 50 years. FNAC diagnosed 94 patients with benign disease and 18 patients with malignant disease. Final histopathological analysis of post-surgical specimens revealed that 86 cases had benign pathology, while 26 had malignant disease. Pleomorphic adenoma was the most common pathology observed in both FNAC and histopathological analysis. The diagnostic performance of FNAC in identifying parotid gland pathology was as follows: sensitivity, 65.38%; specificity, 98.83%; accuracy, 91.07%; positive predictive value (PPV), 94.4%; negative predictive value (NPV), 90.42%; positive likelihood ratio (LR+), 55.88; and negative likelihood ratio (LR-), 0.35. Conclusions Our findings demonstrate that FNAC has good accuracy in distinguishing benign lesions from malignant ones. FNAC is a readily available, repeatable, inexpensive, minimally invasive, and relatively painless outpatient procedure with no known serious complications. While a relatively low sensitivity may limit its standalone diagnostic value, its high specificity, PPV, NPV, and LR+ underscore its importance as a valuable diagnostic tool in the evaluation of parotid gland swellings.
背景 腮腺肿大是最常见的唾液腺病变。细针穿刺细胞学检查（FNAC），除了作为评估腮腺肿大的一线诊断工具外，在规划手术和非手术治疗中都起着不可或缺的作用。目的 确定FNAC在评估腮腺肿大中的诊断准确性。方法 对自2010年以来在卡纳塔克邦班加罗尔拉马亚医学院和医院接受腮腺病变手术的所有患者的病历进行回顾性分析。提取、评估人口统计学数据、FNAC报告和最终组织病理学报告并进行统计分析。结果 在研究期间接受腮腺肿大手术的193例患者中，112例纳入研究。该队列包括67例男性和45例女性患者，平均年龄50岁。FNAC诊断出94例良性疾病患者和18例恶性疾病患者。手术标本的最终组织病理学分析显示，86例为良性病理，26例为恶性疾病。多形性腺瘤是在FNAC和组织病理学分析中观察到的最常见病理。FNAC在识别腮腺病理方面的诊断性能如下：敏感性为65.38%；特异性为98.83%；准确性为91.07%；阳性预测值（PPV）为94.4%；阴性预测值（NPV）为90.42%；阳性似然比（LR+）为55.88；阴性似然比（LR-）为0.35。结论 我们的研究结果表明，FNAC在区分良性病变和恶性病变方面具有良好的准确性。FNAC是一种随时可用、可重复、廉价、微创且相对无痛的门诊手术，没有已知的严重并发症。虽然相对较低的敏感性可能会限制其独立诊断价值，但其高特异性、PPV、NPV和LR+强调了其作为评估腮腺肿大的有价值诊断工具的重要性。
