Murthy P, Laing M R, Palmer T J
Department of Otolaryngology, Raigmore Hospital NHS Trust, Inverness, UK.
J R Coll Surg Edinb. 1997 Oct;42(5):341-6.
Fine needle aspiration cytology (FNAC) was performed on 91 patients with lesions of salivary glands and cervical lymph nodes. The results were compared with histopathology in 58 patients who subsequently underwent surgery. Of a total of 105 aspirates, a definitive cytodiagnosis was possible in 88 (83.8%). An overall sensitivity of 77.7% and specificity of 93.3% were obtained when the cytological results were correlated with histopathology in 48 cases. The figures for salivary glands were 40.0 and 88.9%, and for cervical lymph nodes were 92.3 and 100.0% respectively. The incorrect diagnosis of some aspirates did not adversely affect the subsequent management of these cases. Fine needle aspiration cytology has a role in the diagnosis and management of a variety of head and neck lesions, although it should be used, along with other investigations, not as a substitute but as an adjunct to sound clinical judgement. The limitations of the procedure, including occasional errors of cytodiagnosis, should be borne in mind. The use of this technique by otolaryngologists has been limited, and we advocate that it becomes a more integral part of the diagnostic work-up in head and neck practice.
对91例唾液腺和颈部淋巴结病变患者进行了细针穿刺细胞学检查（FNAC）。将58例随后接受手术的患者的检查结果与组织病理学结果进行了比较。在总共105份穿刺样本中，88份（83.8%）可作出明确的细胞诊断。在48例病例中，将细胞学结果与组织病理学结果相关联时，总体敏感性为77.7%，特异性为93.3%。唾液腺的相应数字分别为40.0%和88.9%，颈部淋巴结的相应数字分别为92.3%和100.0%。一些穿刺样本的错误诊断并未对这些病例的后续治疗产生不利影响。细针穿刺细胞学检查在各种头颈部病变的诊断和治疗中发挥着作用，不过，它应与其他检查一起使用，并非作为替代手段，而是作为合理临床判断的辅助手段。应牢记该检查方法的局限性，包括偶尔出现的细胞诊断错误。耳鼻喉科医生对该技术的使用一直有限，我们主张它应成为头颈部诊疗中诊断检查更不可或缺的一部分。
