Application of Milan system for reporting salivary gland cytopathology in the diagnosis of salivary gland lesions

doi:10.19438/j.cjoms.2025.01.010

Abstract

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

CLC Number:

R781.7

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 Journal of Oral and Maxillofacial Surgery, 2025, 23(1): 55-61.

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