Application of the Milan System for Reporting Pediatric Salivary Gland Cytopathology: Analysis of histologic follow-up, risk of malignancy, and diagnostic accuracy.
Application of the Milan System for Reporting Pediatric Salivary Gland Cytopathology: Analysis of histologic follow-up, risk of malignancy, and diagnostic accuracy.
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DOI：
10.1002/cncy.22415
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发表时间：
2021-07
影响因子：
3.4
通讯作者：
Liang, Jiancong
中科院分区：
文献类型：
--
作者：
Wang, Huiying;Weiss, Vivian Lee;Borinstein, Scott C.;Ely, Kim;Johnson, Joyce;Coogan, Alice;Belcher, Ryan;Mannion, Kyle;Virgin, Frank;Liang, Jiancong
关键词：
儿童涎腺肿瘤的诊断和治疗具有挑战性。尚未系统评估细针穿刺（FNA）细胞病理学的实用性和米兰涎腺细胞病理学报告系统（MSRSGC）在该年龄组中的性能。由于缺乏相关数据，导致FNA细胞病理学在这些患者术前管理中的作用存在争议。我们回顾性分析了104例儿童涎腺FNA（2000-2020年）。评估MSRSGC每个类别的分布百分比、肿瘤风险（罗恩）和恶性肿瘤风险（ROM）。计算总体诊断准确性。研究机构的儿童唾液腺FNA标本的总体敏感性、特异性、阴性预测值和阳性预测值分别为73%、97%、89%和92%。非诊断性、非肿瘤性、AUS、良性肿瘤、SUMP、SM和恶性的罗恩分别为60%、11%、100%、100%、100%和100%，而ROM分别为0%、11%、100%、6%、67%、100%和100%。非肿瘤性FNA的百分比远高于成人人群（52% vs 8%），因为儿科患者中非肿瘤性病变的患病率较高。0-10岁患者的所有肿瘤均为恶性，而良性肿瘤仅发生在11岁或以上的患者中，表明恶性率与年龄呈负相关。细针穿刺细胞病理学在鉴别儿童涎腺良恶性病变方面表现出良好的诊断性能。MSRSGC是这些病变报告标准化和术前风险分层的有价值的工具。细针穿刺细胞病理学在儿童涎腺病变中表现出良好的诊断性能。MSRSGC是这些病变报告标准化和术前风险分层的有价值的工具。
Diagnosis and management of salivary gland tumors in pediatric patients can be challenging. The utility of fine-needle aspiration (FNA) cytopathology and performance of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) in this age group have not been systematically assessed. The paucity of data has contributed to the controversial role of FNA cytopathology in the presurgical management of these patients. We retrospectively analyzed 104 pediatric salivary gland FNAs (2000–2020). Distribution percentages, risk of neoplasm (RON), and risk of malignancy (ROM) were assessed for each category of the MSRSGC. Overall diagnostic accuracy was calculated. The overall sensitivity, specificity, negative predictive value, and positive predictive value of pediatric salivary gland FNA specimens at the study institution were 73%, 97%, 89% and 92%, respectively. The RON for nondiagnostic, nonneoplastic, AUS, benign neoplasms, SUMP, SM, and malignant were 60%, 11%, 100%, 100%, 100%, 100%, and 100%, respectively, while the ROM were 0%, 11%, 100%, 6%, 67%, 100%, and 100%, respectively. The percentage of nonneoplastic FNAs was much higher compared to the adult population (52% vs 8%) due to high prevalence of nonneoplastic lesions in pediatric patients. All neoplasms in patients aged 0–10 were malignant, while benign neoplasms only occurred in patients aged 11 or older, suggesting an inverse correlation between malignancy rate and age. FNA cytopathology demonstrates excellent diagnostic performance in differentiating malignant versus benign pediatric salivary gland lesions. The MSRSGC is a valuable tool for standardization of reporting and preoperative risk stratification of these lesions. FNA cytopathology demonstrates excellent diagnostic performance in pediatric salivary gland lesions. The MSRSGC is a valuable tool for standardization of reporting and preoperative risk stratification of these lesions.
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影响因子：
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