米兰分级系统在唾液腺病变诊断中的应用

doi:10.19438/j.cjoms.2025.01.010

摘要/Abstract

摘要： 目的：探讨米兰分级系统（Milan system for reporting salivary gland cytopathology,MSRSGC)在唾液腺病变诊断中的应用价值。方法：回顾首都医科大学附属北京友谊医院2011年8月—2023年8月收治的2 023例行唾液腺肿物细针穿刺细胞学（fine needle aspiration cytology,FNAC）检查患者,根据MSRSGC进行重新分级,并与组织病理学诊断进行对比分析。结果：根据MSRSGC,76例（3.8%）诊断为Ⅰ级,702例（34.7%）为Ⅱ级,70例（3.5%）为Ⅲ级,801例（39.6%）为Ⅳ级（其中ⅣA级698例,ⅣB级103例）,152例（7.5%）为Ⅴ级,222例（10.9%）为Ⅵ级。根据描述性诊断,非肿瘤性病变848例（41.9%）,主要包括炎性病变、唾液腺肥大及囊肿性病变;肿瘤性病变1 175例（58.1%）,其中多形性腺瘤395例,Warthin瘤303例,腺样囊性癌73例,基底细胞腺瘤53例,黏液表皮样癌48例,导管癌24例,腺泡细胞癌17例,其他各种肿瘤262例。对209例活检或切除标本与组织病理学诊断进行对比分析发现,FNAC对唾液腺肿瘤诊断准确率为98.5%（206/209）,敏感度为100%（183/183）,特异度为88.5%（23/26）。结论：在唾液腺病变的诊断中,FNAC具有操作简单、安全、经济有效、快速及准确的优点。MSRSGC可为FNAC报告提供统一和标准化模式。

关键词: 细针穿刺细胞学, 米兰分级系统, 唾液腺病变

Abstract: PURPOSE: To explore the value of Milan system for reporting salivary gland cytopathology(MSRSGC) in the diagnosis of salivary gland lesions. METHODS: A total of 2 023 patients with salivary gland fine needle aspiration cytology admitted to Beijing Friendship Hospital, Capital Medical University from August 2011 to August 2023 were retrospectively reviewed. MSRSGC was re-graded and compared with histopathological diagnosis. RESULTS: According to MSRSGC, 76 cases(3.8%) were diagnosed as gradeⅠ, 702 cases (34.7%) were diagnosed as grade Ⅱ, 70 cases (3.5%) were diagnosed as Grade Ⅲ, 801 cases (39.6%) were diagnosed as grade Ⅳ (including 698 cases of grade ⅣA and 103 cases of grade ⅣB), 152 cases(7.5%) were diagnosed as grade Ⅴ, 222 cases (10.9%) were diagnosed as grade Ⅵ. According to descriptive diagnosis, there were 848 cases(41.9%) of non-tumor lesions, mainly including inflammatory lesions, salivary gland hypertrophy and cystic lesions. There were 1175 cases(58.1%) of tumor lesions, mainly including 395 cases of pleomorphic adenoma, 303 cases of Warthin's tumor, 73 cases of adenoid cystic carcinoma, 53 cases of basal cell adenoma, 48 cases of mucoepidermoid carcinoma, 24 cases of ductal carcinoma, 17 cases of acinar cell carcinoma, and 262 cases of various other tumors. A retrospective study found that 209 cases were biopsy or resection specimens from our hospital. Compared with histopathological diagnosis, the accuracy of FNAC in diagnosing salivary gland tumors was 98.5% (206/209), the sensitivity was 100%(183/183), and the specificity was 88.5%(23/26). CONCLUSIONS: In the diagnosis of salivary gland masses, FNAC has the advantages of simple operation, safety, cost-effectiveness, fast reporting, and accuracy. MSRSGC provides a standardized uniform framework for FNAC reporting.

Key words: Fine needle aspiration cytology, Milan grading system, Salivary gland lesions

中图分类号:

R781.7

王苗, 杨艳, 余小蒙. 米兰分级系统在唾液腺病变诊断中的应用[J]. 中国口腔颌面外科杂志, 2025, 23(1): 55-61.

WANG Miao, YANG Yan, YU Xiao-meng. Application of Milan system for reporting salivary gland cytopathology in the diagnosis of salivary gland lesions[J]. China J Oral Maxillofac Surg, 2025, 23(1): 55-61.

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