Diagnostic Accuracy of Fine Needle Aspiration Cytology for High-Grade Salivary Gland Tumors

Kim, Bo Young; Hyeon, Ji-Yeon; Ryu, Gwanghui; Choi, Nayeon; Baek, Chung‐Hwan; Ko, Young‐Hyeh; Jeong, Han‐Sin

doi:10.1245/s10434-013-2903-z

Cited by 56 publications

(60 citation statements)

References 38 publications

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“…If other clinical and radiological indicators for malignancy were further combined with the Milan System, then the diagnostic values would likely increase high enough to predict the high‐grade malignancy. In addition, the diagnostic accuracy of FNAC predicting high‐grade salivary gland tumor are relatively high; thus it seems to be clinically useful to incorporate the diagnostic information of FNAC about tumor grade (high‐grade) into the Milan System.…”

Section: Discussionmentioning

confidence: 99%

Risk of high‐grade malignancy in parotid gland tumors as classified by the Milan System for Reporting Salivary Gland Cytopathology

Park

Bae

Park

et al. 2019

J Oral Pathology Medicine

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Background The Milan System for Reporting Salivary Gland Cytopathology (Milan System) has previously shown its diagnostic utility by categorizing the seven cytology findings in salivary gland lesions. However, there has been lack of study about the risk of high‐grade malignancy in the cytology diagnosis based on the Milan System. Thus, we tried to identify the diagnostic ability of the Milan System for high‐grade malignancy and to suggest an improved diagnostic approach for preoperative estimation of high‐grade malignancy using the Milan System. Methods A total of 413 patients with parotid gland tumors, who had undergone surgical resection from 2011 to 2015 were included in the present study retrospectively. Cytopathology was reclassified according to the Milan System by two independent reviewers. The outcomes were risk of malignancy and risk of high‐grade malignancy. The diagnostic performance of the Milan System category [Malignant] for detecting high‐grade malignancy was calculated. Results The risk of malignancy was 83.3% and 100% in the Milan System categories [Suspicious for Malignancy] and [Malignant], respectively. Meanwhile, the risk of high‐grade malignancy was 16.7% and 55.9% in these two categories. Disease‐free survival of patients with high‐grade malignancy was significantly worse than those with low‐ and intermediate‐grade malignancy. Union combining the Milan System category [Malignant] with the presence of nodal metastasis suggested high‐grade malignancy with an acceptable diagnostic sensitivity (0.889‐0.963) and negative predictive value (0.900‐0.966). Conclusions The Milan System category [Malignant] with the presence of nodal metastasis suggested parotid gland tumors as high‐grade malignancy in a pretreatment setting.

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Section: Discussionmentioning

confidence: 99%

Risk of high‐grade malignancy in parotid gland tumors as classified by the Milan System for Reporting Salivary Gland Cytopathology

Park

Bae

Park

et al. 2019

J Oral Pathology Medicine

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“…The cytological result is useful in terms of both surgical planning and patient counselling (8). The cytological diagnosis mainly aims to differentiate malignant from benign lesions (2).…”

Section: Discussionmentioning

confidence: 99%

“…A non-diagnostic cytology is one of the major drawbacks of FNAB, and it ranges between 3% and 34% (8,16). This may be due to low cellularity, necrosis, bleeding, or improper technique (3,8).…”

Section: Discussionmentioning

confidence: 99%

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Role of Fine-Needle Aspiration Biopsy in the Management of Salivary Gland Masses

Edızer¹,

Server²,

Yiğit³

et al. 2016

Turk Arch Otorhinolaryngol

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Objective: Fine-needle aspiration biopsy (FNAB) is widely used in the management of salivary gland masses. Its main advantage is its ability to differentiate benign from malignant disease. In this study, we aimed to evaluate the diagnostic ability of FNAB in salivary gland masses. Methods:The records of patients who had undergone FNAB before parotidectomy or submandibular gland excision between 2005 and 2013 were retrospectively analyzed. FNAB results were classified as negative, positive, suspicious for malignancy, and non-diagnostic. Preoperative FNAB results were compared with definitive histopathological results. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of FNAB results were calculated.Results: A total of 285 patients were enrolled. Among them, 230 (80.7%) had parotid gland and 55 (19.3%) had submandibular gland masses. Following a definitive histopathological examination, the most common benign tumor was pleomorphic adenoma (52.6%), whereas malignant tumors were mucoepidermoid carcinoma (2%) and squamous cell carcinoma (2%). The sensitivity, specificity, PPV, NPV and accuracy of FNAB results were 76.9%, 95.4%, 75%, 95.9%, and 92.6%, respectively. The rate of a suspicious cytology was 5.2% (15 patients) and that of a non-diagnostic cytology was 8.8% (25 patients). Conclusion:FNAB is a safe and simple diagnostic tool for the diagnosis of salivary gland masses and has a relatively high sensitivity and specificity. It may provide valuable information for patient counselling and surgical planning. The major drawbacks include a lower sensitivity than specificity and a relatively high rate of non-diagnostic results.

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“…However, data supporting the accuracy of cytology in prediction of tumor grade remain controversial. While Zbaren et al showed that FNA could accurately predict tumor grade in only one-third of parotid malignancies; other studies note high sensitivity, specificity, and diagnostic accuracy of cytology in identifying high-grade malignancy [13,14]. Because of these controversies and limitations, some clinicians propose the use of image-guided core needle biopsies as an alternative with improved diagnostic accuracy [15].…”

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confidence: 99%

The diagnostic challenge of salivary gland malignancies

Manosalva

Panwar

2016

Expert Review of Anticancer Therapy

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Diagnostic Accuracy of Fine Needle Aspiration Cytology for High-Grade Salivary Gland Tumors

Abstract: FNAC has an excellent diagnostic performance in discriminating high-grade salivary cancer, which guides clinical decision and surgical planning in salivary gland tumors.

Cited by 56 publications

References 38 publications

Risk of high‐grade malignancy in parotid gland tumors as classified by the Milan System for Reporting Salivary Gland Cytopathology

Risk of high‐grade malignancy in parotid gland tumors as classified by the Milan System for Reporting Salivary Gland Cytopathology

Role of Fine-Needle Aspiration Biopsy in the Management of Salivary Gland Masses

The diagnostic challenge of salivary gland malignancies

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