细针吸取活检在下颌下腺肿物诊断中的价值及误诊原因分析  

The value of fine-needle aspiration biopsy in the diagnosis of submandibular gland tumors and the analysis of the causes of misdiagnosis

作　　者：王振 申明明 余小蒙[2] 高润涛[1] WANG Zhen;SHEN Ming-ming;YU Xiao-meng;GAO Run-tao(Department of Stomatology,Beijing Friendship Hospital,Capital Medical University,Beijing,100050,China;不详)

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 [2]首都医科大学附属北京友谊医院病理科,北京100050

出　　处：《北京口腔医学》2024年第2期102-104,共3页Beijing Journal of Stomatology

摘　　要：目的探讨细针吸取活检(FNA)对下颌下腺肿物的诊断价值。方法回顾2013-2022年就诊于首都医科大学附属北京友谊医院口腔科,行FNA并获得最终病理的下颌下腺肿物患者,以最终病理为金标准,计算FNA诊断各型下颌下腺肿物的准确性、灵敏度、特异性、安全性,分析误诊原因。结果共纳入114例患者。非肿瘤性疾病多为IgG4-RD,FNA诊断准确度为91.2%,灵敏度97.4%,特异性88.2%。FNA诊断下颌下腺良性肿瘤准确度:86.8%,灵敏度:81.7%,特异度:92.6%。FNA诊断下颌下腺恶性肿瘤准确度为93.0%,灵敏度62.5%,特异性98.0%。误诊原因包括10例取样误差及8例病理类型误判。结论FNA在诊断IgG4相关性下颌下腺炎中极具价值,在诊断下颌下腺恶性肿瘤灵敏度较低,有误诊可能,需结合患者资料进行综合考虑。Objective To investigate the diagnostic value of fine needle aspiration(FNA)in submandibular gland masses.Methods The patients with submandibular gland masses who received FNA and surgical biopsy were retrospectively analyzed.The accuracy,sensitivity,specificity of FNA in diagnosing various types of submandibular gland masses were calculated,and the causes of misdiagnosis were analyzed.Results A total of 114 patients were enrolled.Non-neoplastic diseases were mostly IgG4-RD.The accuracy,sensitivity and specificity of FNA in the diagnosis of submandibular gland non-neoplastic diseases were 91.2%,97.4%and 88.2%respectively.The accuracy,sensitivity and specificity of FNA in the diagnosis of submandibular gland benign tumor were 86.8%,81.7%and 92.6%respectively.The accuracy,sensitivity and specificity of FNA in the diagnosis of submandibular gland malignant tumor were 93.0%,62.5%and 98.0%respectively.The reasons for misdiagnosis included sampling miss in 10 cases and pathological misdiagnosis in 8 cases.Conclusions FNA is of great value in the diagnosis of IgG4 associated submandibular gland inflammation.The sensitivity of FNA in the diagnosis of submandibular gland malignant tumor is low,and there is the possibility of misdiagnosis.The use of FNA needs to be comprehensively considered in combination with clinical data.

关 键 词：细针吸取活检 下颌下腺肿瘤 IGG4相关性疾病 敏感性和特异性 

分 类 号：R739.8[医药卫生—肿瘤]