Araştırma Makalesi
BibTex RIS Kaynak Göster

Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu

Yıl 2023, Cilt: 49 Sayı: 3, 285 - 290, 31.12.2023

Özlem Saraydaroğlu Selin Yirmibeş

https://doi.org/10.32708/uutfd.1300787

Öz

Tükürük bezi ince iğne aspirasyon sitolojisi (İİAS) raporlamasında, lezyonların malignite riskinin gruplandırılması ve standart terminolojinin kullanımı hedeflenerek Milan Sınıflandırma Sistemi ortaya çıkmıştır. Çalışmada, tükürük bezi lezyonlarında İİAS’nin tanı uyumluluğunun değerlendirilmesi ve Milan Sistemi kullanılarak sitolojik değerlendirmenin doğruluk oranının saptanması amaçlanmıştır. Ocak 2011- Şubat 2023 yılları arasında, merkezimizde tükürük bezi İİAS ve eksizyonel biyopsi uygulanmış olup histopatolojik tanısına ulaşılabilen 270 hastadan oluşan çalışma grubu oluşturuldu. İİAS tanıları biyopsi sonuçları ile karşılaştırıldı. Testin neoplaziyi ve maligniteyi saptamadaki duyarlılığı, özgüllüğü, pozitif/negatif belirleyicilik değerleri ve doğruluk oranı hesaplandı. Her tanı kategorisi için malignite riski değerleri yüzde olarak saptandı. 270 olgunun İİAS tanıları %9,6 tanısal olmayan, %21,1 non-neoplastik, %2,2 önemi belirsiz atipi, %48,5 benign, %2,6 malignite potansiyeli belirsiz, %10,4 malignite şüphesi ve %5,6 malign şeklindeydi. Non-neoplastik tanısı alan olguların histopatolojik tanı uyum oranı %40,4’tü. Non-neoplastik tanısı alan olguların en sık karıştığı antite Warthin tümörü olarak belirlendi. Benign olgularda tanı uyumu %87,8, tümör alt tip uyum oranı ise %94,4’tü. Benign grupta en sık saptanan tanı pleomorfik adenomdu. Malignitenin saptanmasında İİAS duyarlılığı %64, özgüllüğü %94,2, pozitif ve negatif belirleyicilik değerleri sırasıyla %74,4 ve %90,8, yöntemin doğruluk oranı ise %87,8 bulundu. Neoplazi saptanmasında ise duyarlılık %83,3, özgüllük %67,6, pozitif ve negatif belirleyicilik değerleri sırasıyla %93,9 ve %40,3, yöntemin doğruluk oranı %81,1 olarak saptandı. Tükürük bezi lezyonlarında İİAS’nin Milan Sistemi kullanılarak raporlanmasının, klasik morfolojik özellikler gösteren lezyonlarda yüksek tanısal doğruluk gösterdiği gösterilmiştir. Bu sınıflama, özellikle ara tanılarda ve şüpheli lezyonlarda, tanı standardizasyonunu sağlamanın yanı sıra her kategori için malignite riskini de belirttiğinden tüm merkezler tarafından kullanılmalıdır.

Anahtar Kelimeler

İnce iğne aspirasyonu Histopatoloji Milan Sitoloji Tükürük bezi

Kaynakça

  • 1. Savant D, Jin C, Chau K, et al. Risk stratification of salivary gland cytology utilizing the Milan system of classification. Diagn Cytopathol 2019;47(3):172–80.
  • 2. Kala C, Kala S, Khan L. Milan system for reporting salivary gland cytopathology: An experience with the implication for risk of malignancy. J Cytol 2019;36(3):160–4.
  • 3. Pahwa S, Panjwani P, Gnanapriya V. Reclassification of salivary gland aspirates based on “The Milan system for reporting salivary gland cytology”: A five-year retrospective study. J Cytol 2022;39(3):98.
  • 4. Mairembam P, Jay A, Beale T, et al. Salivary gland FNA cytology: role as a triage tool and an approach to pitfalls in cytomorphology. Cytopathology 2016;27(2):91–6.
  • 5. Wang Z, Zhao H, Guo H, An C. Application of the Milan System for Reporting Salivary Gland Cytopathology: A systematic review and meta‐analysis. Cancer Cytopathol 2022;130(11):849–59.
  • 6. Katabi N, Wenig BM, Baloch Z, Field AS. The Milan system for reporting salivary gland cytopathology. In: Faquin WC, Rossi ED, Baloch Z, Barkan GA (eds). The Milan System for Reporting Salivary Gland Cytopathology. 1st edition. Switzerland: Springer International Publishing AG; 2018. 1–9.
  • 7. Faquin WC, Powers CN. Salivary Gland FNA: Anatomic, Clinical, and Technical Considerations. In: Rosenthal DL (ed). Salivary Gland Cytopathology. 1st edition. Springer Science+Business Media, LLC; 2008. 17–28.
  • 8. Salehi S, Maleki Z. Diagnostic challenges and problem cases in salivary gland cytology: A 20-year experience. Cancer Cytopathol 2018;126(2):101–11.
  • 9. Singh S, Singh P, Auplish R, et al. Application of Milan system for reporting of salivary gland pathology and risk stratification: An institutional experience. J Oral Maxillofac Pathol 2020;24(2):266.
  • 10. Rossi ED, Faquin WC. The Milan system for reporting salivary gland cytopathology: The clinical impact so far. Considerations from theory to practice. Cytopathology 2020;31(3):181–4.
  • 11. Allison DB, Smith AP, An D, et al. Assessing the diagnostic accuracy for pleomorphic adenoma and Warthin tumor by employing the Milan System for Reporting Salivary Gland Cytopathology: An international, multi‐institutional study. Cancer Cytopathol 2021;129(1):43–52.
  • 12. Lee DY, Song S, Yang SK, et al. Prediction of Malignancy in Salivary Gland Tumors by a New Cytology Reporting System. Ear, Nose Throat J 2021;100(10):NP432–7.
  • 13. Fisher R, Ronen O. Cytologic diagnosis of parotid gland Warthin tumor: Systematic review and meta-analysis. Head Neck 2022;44(10):2277–87.
  • 14. Rammeh S, Romdhane E, Ksentini M, et al. Accuracy of fine-needle aspiration cytology in the diagnosis of salivary gland masses according to the Milan reporting system and to an in-house system. Diagn Cytopathol 2021;49(4):528–32.
  • 15. Manucha V, Gonzalez MF, Akhtar I. Impact of the Milan System for Reporting Salivary Gland Cytology on risk assessment when used in routine practice in a real-time setting. J Am Soc Cytopathol 2021;10(2):208–15.
  • 16. Park JH, Cha YJ, Seo JY, Lim JY, Hong SW. A retrospective cytohistological correlation of fine-needle aspiration cytology with classification by the Milan System for Reporting Salivary Gland Cytopathology. J Pathol Transl Med 2020;54(5):419–25.
  • 17. Wang H, Fundakowski C, Khurana JS, Jhala N. Fine-Needle Aspiration Biopsy of Salivary Gland Lesions. Arch Pathol Lab Med 2015;139(12):1491–7.
  • 18. Haberal Can İ, Yazıcı H, Ünlü İ, Uzunkulaoğlu H, Samim E. Tükürük Bezi Lezyonlarında İnce İğne Aspirasyon Biyopsisi ve Histopatolojik İnceleme Sonuçlarının Karşılaştırılması. Turkiye Klin J Med Sci 2009;29(5):1230–4.
  • 19. Rohilla M, Singh P, Rajwanshi A, et al. Three-year cytohistological correlation of salivary gland FNA cytology at a tertiary center with the application of the Milan system for risk stratification. Cancer Cytopathol 2017;125(10):767–75.
  • 20. Reerds STH, Engen‐van Grunsven ACH, Hoogen FJA, et al. Validation of the Milan System for Reporting Salivary Gland Cytopathology and the diagnostic accuracy of FNA cytology for submandibular gland lesions. Cancer Cytopathol 2022;130(3):189–94.
  • 21. Chrabańska M, Kiczmer P, Drozdzowska B. Salivary gland lesions: diagnostic reliability and challenges of fine needle aspiration cytology. Int J Clin Exp Pathol 2021;14(1):54–62.

Histopathological Diagnostic Correlation of Salivary Gland Fine Needle Aspiration Cytologies Evaluated According to the Milan Classification System

Yıl 2023, Cilt: 49 Sayı: 3, 285 - 290, 31.12.2023

Özlem Saraydaroğlu Selin Yirmibeş

https://doi.org/10.32708/uutfd.1300787

Öz

The Milan Classification System has emerged with the purpose of using standart terminology and categorizing risk of malignancy for salivary gland lesions, when reporting fine needle aspiration cytology (FNAC). This study aimed to evaluate the diagnostic compatibility of FNAC in salivary gland lesions and to determine the accuracy of cytological evaluation using the Milan System. A study group of 270 patients who underwent salivary gland FNAC and excisional biopsy in our center, between January 2011 and February 2023, was formed. FNAC diagnoses were compared to biopsy results. The sensitivity, specificity, positive/negative predictive values and accuracy of the test in detecting neoplasia and malignancy were calculated. Risk of malignancy was given as percentage for each diagnostic category. FNAC diagnoses of 270 cases were 9.6% non-diagnostic, 21.1% non-neoplastic, 2.2% atypia of undetermined significance, 48.5% benign, 2.6% uncertain malignant potential, 10.4% suspicious for malignancy, and 5.6% malignant. The histopathological diagnostic compatibility rate for non-neoplastic category was 40.4%. Warthin tumor was the most frequently misdiagnosed entity as non-neoplastic. For benign cases, diagnostic compatibility was 87.8% and tumor subtype compatibility was 94.4%. The most common diagnosis in the benign group was pleomorphic adenoma. For detecting malignancy, the sensitivity of FNAC was 64%, specificity was 94.2%, positive and negative predictive values were 74.4% and 90.8%, and the accuracy of the method was 87.8%. For detection of neoplasia, the sensitivity was 83.3%, the specificity was 67.6%, and the positive and negative predictive values were 93.9% and 40.3%, respectively, and the accuracy rate of the method was 81.1%. Reporting of FNAC in salivary gland lesions using the Milan System has been shown to provide high diagnostic accuracy in lesions with classical morphological features. This classification should be in all centers, especially in intermediate diagnoses and suspicious lesions, as it not only provides diagnostic standardization, but also indicates the risk of malignancy for each category.

Anahtar Kelimeler

Cytology Fine needle aspiration Histopathology Milan Salivary gland

Kaynakça

  • 1. Savant D, Jin C, Chau K, et al. Risk stratification of salivary gland cytology utilizing the Milan system of classification. Diagn Cytopathol 2019;47(3):172–80.
  • 2. Kala C, Kala S, Khan L. Milan system for reporting salivary gland cytopathology: An experience with the implication for risk of malignancy. J Cytol 2019;36(3):160–4.
  • 3. Pahwa S, Panjwani P, Gnanapriya V. Reclassification of salivary gland aspirates based on “The Milan system for reporting salivary gland cytology”: A five-year retrospective study. J Cytol 2022;39(3):98.
  • 4. Mairembam P, Jay A, Beale T, et al. Salivary gland FNA cytology: role as a triage tool and an approach to pitfalls in cytomorphology. Cytopathology 2016;27(2):91–6.
  • 5. Wang Z, Zhao H, Guo H, An C. Application of the Milan System for Reporting Salivary Gland Cytopathology: A systematic review and meta‐analysis. Cancer Cytopathol 2022;130(11):849–59.
  • 6. Katabi N, Wenig BM, Baloch Z, Field AS. The Milan system for reporting salivary gland cytopathology. In: Faquin WC, Rossi ED, Baloch Z, Barkan GA (eds). The Milan System for Reporting Salivary Gland Cytopathology. 1st edition. Switzerland: Springer International Publishing AG; 2018. 1–9.
  • 7. Faquin WC, Powers CN. Salivary Gland FNA: Anatomic, Clinical, and Technical Considerations. In: Rosenthal DL (ed). Salivary Gland Cytopathology. 1st edition. Springer Science+Business Media, LLC; 2008. 17–28.
  • 8. Salehi S, Maleki Z. Diagnostic challenges and problem cases in salivary gland cytology: A 20-year experience. Cancer Cytopathol 2018;126(2):101–11.
  • 9. Singh S, Singh P, Auplish R, et al. Application of Milan system for reporting of salivary gland pathology and risk stratification: An institutional experience. J Oral Maxillofac Pathol 2020;24(2):266.
  • 10. Rossi ED, Faquin WC. The Milan system for reporting salivary gland cytopathology: The clinical impact so far. Considerations from theory to practice. Cytopathology 2020;31(3):181–4.
  • 11. Allison DB, Smith AP, An D, et al. Assessing the diagnostic accuracy for pleomorphic adenoma and Warthin tumor by employing the Milan System for Reporting Salivary Gland Cytopathology: An international, multi‐institutional study. Cancer Cytopathol 2021;129(1):43–52.
  • 12. Lee DY, Song S, Yang SK, et al. Prediction of Malignancy in Salivary Gland Tumors by a New Cytology Reporting System. Ear, Nose Throat J 2021;100(10):NP432–7.
  • 13. Fisher R, Ronen O. Cytologic diagnosis of parotid gland Warthin tumor: Systematic review and meta-analysis. Head Neck 2022;44(10):2277–87.
  • 14. Rammeh S, Romdhane E, Ksentini M, et al. Accuracy of fine-needle aspiration cytology in the diagnosis of salivary gland masses according to the Milan reporting system and to an in-house system. Diagn Cytopathol 2021;49(4):528–32.
  • 15. Manucha V, Gonzalez MF, Akhtar I. Impact of the Milan System for Reporting Salivary Gland Cytology on risk assessment when used in routine practice in a real-time setting. J Am Soc Cytopathol 2021;10(2):208–15.
  • 16. Park JH, Cha YJ, Seo JY, Lim JY, Hong SW. A retrospective cytohistological correlation of fine-needle aspiration cytology with classification by the Milan System for Reporting Salivary Gland Cytopathology. J Pathol Transl Med 2020;54(5):419–25.
  • 17. Wang H, Fundakowski C, Khurana JS, Jhala N. Fine-Needle Aspiration Biopsy of Salivary Gland Lesions. Arch Pathol Lab Med 2015;139(12):1491–7.
  • 18. Haberal Can İ, Yazıcı H, Ünlü İ, Uzunkulaoğlu H, Samim E. Tükürük Bezi Lezyonlarında İnce İğne Aspirasyon Biyopsisi ve Histopatolojik İnceleme Sonuçlarının Karşılaştırılması. Turkiye Klin J Med Sci 2009;29(5):1230–4.
  • 19. Rohilla M, Singh P, Rajwanshi A, et al. Three-year cytohistological correlation of salivary gland FNA cytology at a tertiary center with the application of the Milan system for risk stratification. Cancer Cytopathol 2017;125(10):767–75.
  • 20. Reerds STH, Engen‐van Grunsven ACH, Hoogen FJA, et al. Validation of the Milan System for Reporting Salivary Gland Cytopathology and the diagnostic accuracy of FNA cytology for submandibular gland lesions. Cancer Cytopathol 2022;130(3):189–94.
  • 21. Chrabańska M, Kiczmer P, Drozdzowska B. Salivary gland lesions: diagnostic reliability and challenges of fine needle aspiration cytology. Int J Clin Exp Pathol 2021;14(1):54–62.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Patoloji
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Özlem Saraydaroğlu 0000-0002-4127-9656

Selin Yirmibeş 0000-0002-8211-6175

Yayımlanma Tarihi 31 Aralık 2023
Kabul Tarihi 27 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 49 Sayı: 3

Kaynak Göster

APA Saraydaroğlu, Ö., & Yirmibeş, S. (2023). Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 49(3), 285-290. https://doi.org/10.32708/uutfd.1300787
AMA Saraydaroğlu Ö, Yirmibeş S. Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu. Uludağ Tıp Derg. Aralık 2023;49(3):285-290. doi:10.32708/uutfd.1300787
Chicago Saraydaroğlu, Özlem, ve Selin Yirmibeş. “Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 49, sy. 3 (Aralık 2023): 285-90. https://doi.org/10.32708/uutfd.1300787.
EndNote Saraydaroğlu Ö, Yirmibeş S (01 Aralık 2023) Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu. Uludağ Üniversitesi Tıp Fakültesi Dergisi 49 3 285–290.
IEEE Ö. Saraydaroğlu ve S. Yirmibeş, “Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu”, Uludağ Tıp Derg, c. 49, sy. 3, ss. 285–290, 2023, doi: 10.32708/uutfd.1300787.
ISNAD Saraydaroğlu, Özlem - Yirmibeş, Selin. “Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 49/3 (Aralık 2023), 285-290. https://doi.org/10.32708/uutfd.1300787.
JAMA Saraydaroğlu Ö, Yirmibeş S. Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu. Uludağ Tıp Derg. 2023;49:285–290.
MLA Saraydaroğlu, Özlem ve Selin Yirmibeş. “Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 49, sy. 3, 2023, ss. 285-90, doi:10.32708/uutfd.1300787.
Vancouver Saraydaroğlu Ö, Yirmibeş S. Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu. Uludağ Tıp Derg. 2023;49(3):285-90.
 Kapak Resmi İndir

ISSN: 1300-414X, e-ISSN: 2645-9027

Uludağ Üniversitesi Tıp Fakültesi Dergisi "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License" ile lisanslanmaktadır.


Creative Commons License
Journal of Uludag University Medical Faculty is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

2023