Tanaka K, Masuda M, Shinden S, Ogata A, Suzuki M
Department of Otorhinolaryngology, Yokohama Municipal Citizen's Hospital, Kanagawa.
Nihon Jibiinkoka Gakkai Kaiho. 1998 Oct;101(10):1283-91. doi: 10.3950/jibiinkoka.101.10_1283.
Between 1986 and 1997, 124 patients with tumors of major salivary glands (93 parotid tumors, 31 submandibular gland tumors) were assessed by fine-needle aspiration cytology (FNAC). The 124 cases included 28 cases of primary malignant tumors and 96 cases of benign lesions. The preoperative fine-needle diagnoses were compared with postoperative pathologic findings. Sensitivity for malignancy was 64%, and specificity was 99%. Overall accuracy was 91%, and the predictive value for malignancy was 95%. FNAC allowed determination of histogenesis in 13 (68%) of the 19 cases cytologically diagnosed as malignant, and in 72 (71%) of the 105 cases cytologically diagnosed as benign. The diagnostic accuracy for histologic diagnosis of malignant neoplasms, pleomorphic adenoma, and Warthin's tumor was 46%, 73%, and 82%, respectively. The predictive value for specific histologic diagnosis of malignancy, pleomorphic adenoma, and Warthin's tumor was 100%, 91%, and 100%, respectively. The diagnostic accuracy and the predictive value for histologic diagnoses were relatively high (> 70%) for squamous cell carcinoma, adenocarcinoma, malignant lymphoma, pleomorphic adenoma, and Warthin's tumor. Adenoid cystic carcinoma and low-grade malignancies such as mucoepidermiod carcinoma and acinic cell carcinoma were the lesions most frequently misdiagnosed.
1986年至1997年间，对124例大唾液腺肿瘤患者（93例腮腺肿瘤，31例颌下腺肿瘤）进行了细针穿刺细胞学检查（FNAC）。这124例病例包括28例原发性恶性肿瘤和96例良性病变。将术前细针诊断结果与术后病理结果进行比较。恶性肿瘤的敏感性为64%，特异性为99%。总体准确率为91%，恶性肿瘤的预测值为95%。FNAC能够在19例细胞学诊断为恶性的病例中的13例（68%）以及105例细胞学诊断为良性的病例中的72例（71%）中确定组织发生情况。恶性肿瘤、多形性腺瘤和沃辛瘤组织学诊断的诊断准确率分别为46%、73%和82%。恶性肿瘤、多形性腺瘤和沃辛瘤特异性组织学诊断的预测值分别为100%、91%和100%。鳞状细胞癌、腺癌、恶性淋巴瘤、多形性腺瘤和沃辛瘤的组织学诊断的诊断准确率和预测值相对较高（>70%）。腺样囊性癌以及黏液表皮样癌和腺泡细胞癌等低级别恶性肿瘤是最常被误诊的病变。
