细针吸取细胞学检查对腮腺肿物的诊断价值  

Value of fine-needle aspiration cytology of parotid masses

作　　者：苏莎[1] 高润涛[1] 耿雪霏[1] 马华瑞 

机构地区：[1]首都医科大学附属北京友谊医院口腔科,北京100050

出　　处：《口腔医学》2017年第5期426-429,共4页Stomatology

基　　金：国家自然科学基金(81271164)

摘　　要：目的探讨细针吸取细胞学检查(FNAC)对腮腺肿物的诊断价值。方法回顾性分析2013—2016年首都医科大学附属北京友谊医院口腔科98例行FNAC的腮腺肿物的病历资料,以最终组织病理学诊断结果为金标准。计算FNAC对各腮腺肿物诊断的准确率,对非肿瘤性病变及恶性肿瘤诊断的灵敏度、特异度、阳性预测值及阴性预测值。结果 FNAC诊断腮腺肿物的准确率依次为:非肿瘤性病变(88.9%)>良性肿瘤(74.0%)>恶性肿瘤(56.3%);FNAC诊断非肿瘤性病变灵敏度:88.9%,特异度为:91.0%,阳性预测值:50.0%,阴性预测值:98.8%;FNAC诊断腮腺恶性肿瘤灵敏度:87.5%,特异度为:97.6%,阳性预测值:87.5%,阴性预测值:97.6%,假阳性病例为1例腮腺囊肿和1例多形性腺瘤,假阴性病例为2例恶性淋巴瘤误诊为沃辛瘤。结论 FNAC对腮腺非肿瘤性病变及良性肿瘤的诊断准确率高,恶性肿瘤的灵敏度特异度好,是一种有较好诊断价值的诊断手段,假阳性及假阴性病例,需要结合超声引导下穿刺、免疫组化及术中冰冻结果。Objective To evaluate the effectiveness of FNAC as a preoperative diagnostic tool of parotid masses. Methods The medical histories of 98 patients who had satisfactory preoperative FNAC and underwent subsequent surgery to the parotid between 2013 and 2016 at our institution were retrospectively analyzed, taking the final results of the histopathologieal diagnosis as the standard. Re- sults The results of the FNAC were compared with the permanent histopathological diagnosis assays. Rates of accuracy of FNAC for parotid masses were, in turn, non-neoplasm （ 88.9% ）, benign tumor （ 74.0% ） andmalignant tumor （ 56.3% ）. The sensitivity, specifi- cty, positive predictive value and the nagtive predictive value of FNAC for non-neoplasm, 88.9%, 91.0%, 50.0%, 98.8%, respective- ly; for malignant tumor were 87.5%, 97.6%, 87.5%, 97.6%, respetively. Two false positive cases were cyst of parotid gland and pleo- morphie adenoma. The false negative cases were malignant lymphoma of parotid. Conclusion FNAC is useful in the preoperative as- sessment of parotid masses and surgical planning. Ultrasound-guided puncture and biopsy, tissue biopsy for histologic examination and frozen section may be necessary for few misdiagnosed cases.

关 键 词：细针吸取细胞学检查 腮腺肿物 灵敏度 特异度 恶性淋巴瘤 

分 类 号：R739.87[医药卫生—肿瘤]