Takashima S, Takayama F, Wang Q, Kurozumi M, Sekiyama Y, Sone S
Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan.
Head Neck. 1999 Jan;21(1):43-51. doi: 10.1002/(sici)1097-0347(199901)21:1<43::aid-hed6>3.0.co;2-i.
The purpose of this study was to assess the capability of magnetic resonance imaging (MRI) and cytology and flow cytometric (FCM) deoxyribonucleic acid (DNA) analysis in fine-needle aspiration biopsy (FNAB)-derived materials for diagnosing malignancy of the parotid lesions and the efficacy of FCM analysis in FNAB.
Magnetic resonance imaging findings and FCM results (ploidy and S + G2 + M phases [S + G2M] fraction) and cytology in FNAB-derived materials in 26 patients with 26 parotid lesions (12 benign lesions, 14 malignancies) were assessed for predicting malignancy. Flow cytometric results in aspirates were compared with those in surgically resected tissues.
When a single predictor was used, cytology (92% accuracy) was most accurate for malignancy, followed by ill-defined margin (88% accuracy) and aneuploidy (88% accuracy). The combination of FCM and cytology raised the rate of sufficient materials from 92% to 100% and accuracy from 92% to 96% compared with cytology alone. The same highest accuracy (96%) was obtained with the combination of the ill-defined margin or other findings such as cytology, aneuploidy, or a high (S + G2M) fraction (6% <). Deoxyribonucleic acid ploidy in the FNAB showed full agreement with that in the surgical specimens. Receiver operating characteristic curves showed that the diagnosis of malignancy with (S + G2M) fraction in FNAB was superior to that in surgical specimens, but no significant difference was noted.
A combination of MRI findings, cytology, and FCM results is optimal for diagnosing malignancies of the parotid lesions, and FNAB may replace the surgical specimens in FCM analysis.
本研究旨在评估磁共振成像（MRI）、细胞学检查以及流式细胞术（FCM）对细针穿刺活检（FNAB）取材进行脱氧核糖核酸（DNA）分析，以诊断腮腺病变恶性肿瘤的能力，以及FCM分析在FNAB中的应用效果。
对26例患有26个腮腺病变（12个良性病变，14个恶性肿瘤）患者的FNAB取材进行MRI检查结果、FCM结果（倍体和S + G2 + M期[S + G2M]比例）及细胞学检查，以预测肿瘤的恶性程度。将穿刺抽吸物的流式细胞术结果与手术切除组织的结果进行比较。
当采用单一预测指标时，细胞学检查（准确率92%）对恶性肿瘤的诊断最为准确，其次是边界不清（准确率88%）和非整倍体（准确率88%）。与单独细胞学检查相比，FCM与细胞学检查相结合使充足取材率从92%提高到100%，准确率从92%提高到96%。边界不清或其他检查结果如细胞学检查、非整倍体或高（S + G2M）比例（>6%）相结合也可获得相同的最高准确率（96%）。FNAB中的DNA倍体与手术标本中的完全一致。受试者工作特征曲线显示，FNAB中（S + G2M）比例对恶性肿瘤的诊断优于手术标本，但差异无统计学意义。
MRI检查结果、细胞学检查和FCM结果相结合是诊断腮腺病变恶性肿瘤的最佳方法，且FNAB在FCM分析中可替代手术标本。
