Milan Raporlama Sistemine göre tanı alan tükrük bezi ince iğne aspirasyon sitolojilerinin 5 yıllık sitolojik-histopatolojik korelasyonu
Yükleniyor...
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Dicle Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Tükrük bezi lezyonlarının tanısında yaygın olarak kullanılan ince iğne aspirasyon (İİA) materyallerinin
değerlendirmesinde standardizasyonu sağlamak amacı ile Milan Raporlama sistemi (MRS) geliştirilmiştir. Çalışmamızda
tükrük bezi İİA sitolojileri incelenerek, sitolojik tanı kategorilerinin histopatolojik tanı ile uyumunun araştırılması ve
Milan raporlama sisteminin etkinliğinin değerlendirilmesi amaçlanmıştır.
Yöntemler: 1 Ocak 2017 ile 31 Aralık 2021 tarihleri arasında merkezimize önce tükrük bezi İİA materyali ve daha sonra
rezeksiyon materyali gönderilen 79 olgu çalışma kapsamına alındı. Olguların demografik, radyolojik, klinik bulguları ve
MRS’ye göre revize edilen sitomorfolojik tanıları değerlendirildi. Her kategori için malignite riski (MR) ve neoplazi riski
(NR) oranları hesaplandı. İİA’nın sensitivite, spesifite, pozitif prediktif değer ve negatif prediktif değerleri belirlendi.
Bulgular: Olguların 34’ü kadın, 45’i erkektir. Erkeklerde malignite oranı %29, kadınlarda %18’dir. Lezyonların %96’sı
parotis, %4’ü submandibular gland yerleşimli olup, ortalama lezyon çapı benign olgularda 2,7 cm, malign olgularda 3,2
cm’dir. Olgular MRS tanı kategorilerine göre analiz edildiğinde 3 olgu nondiagnostik (ND, %4), 6 olgu nonneoplastik (NN,
%8), 4 olgu önemi belirsiz atipi (AUS, %5), 46 olgu benignneoplazi (BN, %58), 8 olgu malignite potansiyeli belirsiz tükrük
bezi neoplazisi (SUMP, %10), 4 olgu malignite kuşkusu (MK, %5) ve 8 olgu malign (%10) olarak değerlendirilmiştir. MR
oranları ND, NN, AUS, BN, SUMP, MK, malign kategorilerde sırası ile %33, %0, %50, %0, %63, %75, %100, NR oranları
ise ND’de %67, NN’de %50, AUS’ta %75, BN, SUMP, MK ve malign kategoride %100’dür. Tükrük bezi İİA’nın sensitivitesi
%100, spesifitesi %98, pozitif prediktif değeri %92 ve negatif prediktif değeri %100 olarak belirlendi.
Sonuç: Tükrük bezi İİA sitolojilerinin değerlendirilmesinde kullanılan MRS, MR yönünden NN, BN ve malign
kategorilerde oldukça güvenilir bir sistemdir. Bununla birlikte ara kategorilerilerde tanımlanan kriterlerin, geniş olgu
serilerin değerlendirildiği çalışmalara göre yeniden düzenlenmesi gerektiği düşünülmektedir.
Background: Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was developed in order to standardize the evaluation of fine needle aspiration materials, which is common used in the diagnosis of salivary gland lesions. The aims of this study were to investigate the correlation of cytological diagnosis categories with histopathological diagnosis and to evaluate the effectiveness of the Milan reporting system in management of patient. Metods: Between January 1, 2017 and December 31, 2021, 79 patients who were diagnosed in our center and had salivary gland FNA (Fine needle aspiration) material with a histological follow-up were included in the study. Demographic, radiological, clinical findings and cytomorphological diagnoses revised according to MSRSGC were evaluated. The risk of malignancy (ROM) and risk of neoplasia (RON) ratios were calculated according to MSRSGC diagnostic categories. Sensitivity, specificity, positive predictive value and negative predictive values of FNA were determined. Results: Thirty four of the cases were female and 45 were male. The malignancy rate was 29% in men and 18% in women. 96% of the lesions were located in the parotid and 4% in the submandibular gland, and the mean lesion diameter was 2.7 cm in benign cases and 3.2 cm in malignant cases. Based on the MSRSGC categorization 3 cases were classified as nondiagnostic (ND, 4%), 6 cases as non-neoplastic (NN, 8%), 4 cases as atypia of uncertain significance (AUS, 5%), 46 cases as benign neoplasm (BN, 58%), 8 cases as salivary gland neoplasm of uncertain malignant potential (SGNUMP, 10%), 4 cases as suspicious for malignancy (SFM, 5%), and 8 cases as malignant (10%). ROM rates were 33%, 0%, 50%, 0%, 63%, 75%, 100% in ND, NN, AUS, BN, SGNUMP, SM, and malignant categories, respectively. RON rates were 67% in ND, 50% in NN, 75% in AUS, 100% in BN, SGNUMP, SM and malignant category. The sensitivity of salivary gland FNA was 100%, specificity was 98%, positive predictive value was 92%, and negative predictive value was 100%. Conclusion: MSRSGC is a reporting system which used in the evaluation of salivary gland FNA cytology with a high diagnostic reliability in NN, BN and malignant categories. However, it was thought that its effectiveness in patient management could be strengthened by update of the diagnostic criteria that used in the intermediate categories according to current studies.
Background: Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was developed in order to standardize the evaluation of fine needle aspiration materials, which is common used in the diagnosis of salivary gland lesions. The aims of this study were to investigate the correlation of cytological diagnosis categories with histopathological diagnosis and to evaluate the effectiveness of the Milan reporting system in management of patient. Metods: Between January 1, 2017 and December 31, 2021, 79 patients who were diagnosed in our center and had salivary gland FNA (Fine needle aspiration) material with a histological follow-up were included in the study. Demographic, radiological, clinical findings and cytomorphological diagnoses revised according to MSRSGC were evaluated. The risk of malignancy (ROM) and risk of neoplasia (RON) ratios were calculated according to MSRSGC diagnostic categories. Sensitivity, specificity, positive predictive value and negative predictive values of FNA were determined. Results: Thirty four of the cases were female and 45 were male. The malignancy rate was 29% in men and 18% in women. 96% of the lesions were located in the parotid and 4% in the submandibular gland, and the mean lesion diameter was 2.7 cm in benign cases and 3.2 cm in malignant cases. Based on the MSRSGC categorization 3 cases were classified as nondiagnostic (ND, 4%), 6 cases as non-neoplastic (NN, 8%), 4 cases as atypia of uncertain significance (AUS, 5%), 46 cases as benign neoplasm (BN, 58%), 8 cases as salivary gland neoplasm of uncertain malignant potential (SGNUMP, 10%), 4 cases as suspicious for malignancy (SFM, 5%), and 8 cases as malignant (10%). ROM rates were 33%, 0%, 50%, 0%, 63%, 75%, 100% in ND, NN, AUS, BN, SGNUMP, SM, and malignant categories, respectively. RON rates were 67% in ND, 50% in NN, 75% in AUS, 100% in BN, SGNUMP, SM and malignant category. The sensitivity of salivary gland FNA was 100%, specificity was 98%, positive predictive value was 92%, and negative predictive value was 100%. Conclusion: MSRSGC is a reporting system which used in the evaluation of salivary gland FNA cytology with a high diagnostic reliability in NN, BN and malignant categories. However, it was thought that its effectiveness in patient management could be strengthened by update of the diagnostic criteria that used in the intermediate categories according to current studies.
Açıklama
Anahtar Kelimeler
Tükürük bezi, İnce iğne aspirasyonu, Milan raporlama sistemi (MRS), Salivary gland, Fine needle aspiration, Milan system for reporting salivary gland cytopathology (MSRSGC)
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
50
Sayı
3
Künye
Aydoğdu, G. (2023). Milan raporlama sistemine göre tanı alan tükrük bezi ince iğne aspirasyon sitolojilerinin 5 yıllık sitolojik-histopatolojik korelasyonu. Dicle Tıp Dergisi, 50(3), 383-390.
