Surgeon-Performed Ultrasound-Guided Fine-Needle Aspiration Cytology of Head and Neck Mass Lesions: Sampling Adequacy and Diagnostic Accuracy
Surgeon-Performed Ultrasound-Guided Fine-Needle Aspiration Cytology of Head and Neck Mass Lesions: Sampling Adequacy and Diagnostic Accuracy
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DOI：
10.1245/s10434-014-4119-2
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发表时间：
2015-04-01
影响因子：
3.7
通讯作者：
Na, Kyung Jin
中科院分区：
文献类型：
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作者：
Ahn, Dongbin;Kim, Heejin;Na, Kyung Jin
外科医生进行的超声引导细针穿刺细胞学（US-FNAC）的研究主要限于甲状腺结节。本研究评估了外科医生进行的US-FNAC对大范围头颈部肿块病变（包括甲状腺、唾液腺和淋巴结病变）的采样充分性和诊断准确性。该研究包括2009年至2013年期间由一名外科医生进行的617例US-FNAC。他们的病史和超声（US）结果进行了回顾性审查。根据外科医生的经验、解剖肿瘤位置和US肿瘤特征分析样本充足性。结合手术病理结果，计算超声细针穿刺活检的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和诊断准确性，超声细针穿刺活检的诊断准确率为91.9%（567/617）。从9.7%（29/282）的甲状腺、6.1%（6/98）的唾液腺和6.3%（15/237）的淋巴结中获得的标本不足。在100例US-FNAC手术后，外科医生经验的影响趋于稳定（采样率不足，6- 8%）。不充分的采样与肿瘤的特征，如囊性变化和边缘钙化。总体而言，US-FNAC的敏感性为88.2%，特异性为98.2%，PPV为98.5%，NPV为85.7%，诊断准确性为91.6%.With适当的培训和管理至少100例US-FNAC病例的经验，外科医生可以确保低采样率不足和良好的诊断准确性的头颈部肿块病变的范围。
Studies of surgeon-performed ultrasound-guided fine-needle aspiration cytology (US-FNAC) have been limited largely to thyroid nodules. This study evaluated the sampling adequacy and diagnostic accuracy of surgeon-performed US-FNAC for a large range of head and neck mass lesions, including lesions of the thyroid, salivary glands, and lymph nodes.The study included 617 cases of US-FNAC performed by a single surgeon between 2009 and 2013. Their medical histories and ultrasound (US) findings were retrospectively reviewed. Sample adequacy was analyzed according to the surgeon's experience, anatomic tumor location, and US tumor characteristics. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of FNAC were calculated after correlation with the surgical histopathologic results.The overall adequacy rate for surgeon-performed US-FNAC was 91.9 % (567/617). Inadequate specimens were obtained from 9.7 % (29/282) of the thyroid glands, 6.1 % of the salivary glands (6/98), and 6.3 % (15/237) of the lymph nodes. The effect of the surgeon's experience plateaued (inadequate sampling rate, 6-8 %) after 100 US-FNAC procedures. Inadequate sampling was associated with tumor characteristics such as cystic change and rim calcification. Overall, US-FNAC showed a sensitivity of 88.2 %, a specificity of 98.2 %, a PPV of 98.5 %, an NPV of 85.7 %, and a diagnostic accuracy of 91.6 %.With proper training and experience managing at least 100 US-FNAC cases, surgeons can ensure a low inadequate sampling rate and good diagnostic accuracy for a range of head and neck mass lesions.