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Fine needle aspiration cytology in the management of a parotid mass: A two centre retrospective study

机译:腮腺肿块细针穿刺细胞学检查:两个中心的回顾性研究

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Objectives: There is a diversity of opinion regarding the role of fine needle aspiration cytology (FNAC) in the pre-operative evaluation of the parotid mass. This study further investigates the role of FNAC from the standpoint of the clinician attempting to resolve one or more clinical issues. Methods: A retrospective study conducted at two UK Hospitals with no overlap of cytopathologists or surgeons. Patients undergoing parotidectomy at each institution were identified from Pathology department databases. The definitive histopathological diagnosis was compared with any pre-operative FNAC diagnosis. Cytology results were classified as suggestive, non-diagnostic, sampling error, or misleading. Setting: The study was conducted in a District General Hospital and a University Teaching Hospital providing secondary care for each community. Results: For the University Teaching Hospital the sensitivity in distinguishing malignant from benign disease was 79% (95% CI 61-97%) with a specificity 84% (95% CI 73-95%). However, three of eight patients with a primary parotid salivary gland malignancy were reported as having benign disease on FNAC. For the participating District General Hospital the sensitivity in distinguishing malignant from benign disease was 38% (95% CI 13-63%) and specificity 95% (95% CI 73-95%). Conclusions: Fine needle aspiration cytology does not reliably distinguish a benign from a malignant primary salivary gland neoplasm in the participating institutions. Where clinical teams use FNAC in an attempt to resolve this clinical problem, the results should be interpreted with caution and an ongoing audit of performance is required.
机译:目的:关于细针穿刺细胞学检查(FNAC)在腮腺肿块的术前评估中的作用存在多种观点。这项研究从临床医生试图解决一个或多个临床问题的角度进一步研究了FNAC的作用。方法:回顾性研究在两家英国医院进行,细胞病理学家或外科医生没有重叠。从病理部门的数据库中识别出每个机构接受腮腺切除术的患者。将明确的组织病理学诊断与任何术前FNAC诊断进行比较。细胞学结果分类为提示性,非诊断性,抽样错误或误导性。地点:该研究是在地区综合医院和大学教学医院进行的,为每个社区提供二级保健。结果:对于大学教学医院,区分恶性与良性疾病的敏感性为79%(95%CI 61-97%),特异性为84%(95%CI 73-95%)。但是,据报道八名原发性腮腺涎腺恶性肿瘤患者中有三名患有FNAC良性疾病。对于参与的地区综合医院,区分恶性和良性疾病的敏感性为38%(95%CI 13-63%),特异性为95%(95%CI 73-95%)。结论:细针穿刺细胞学检查不能可靠地将良性与恶性原发唾液腺肿瘤区分开来。如果临床团队使用FNAC尝试解决此临床问题,则应谨慎解释结果,并且需要对性能进行持续审核。

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