腮腺腫瘤之細針抽取細胞學檢查

Fine Needle Aspiration Cytology of Parotid Tumors

徐惠珍(Hui-Chen Hsu) ； 游進益(Ching-Yi Yiu) ； 許振益(Chen-Yi Hsu) ； 張銘城(Ming-Chen Chang)

《中華民國耳鼻喉科醫學會雜誌》 33卷6期 (1998/12) Pp. 625-630

https://doi.org/10.6286/1998.33.6.625

摘要

背景:細針抽取細胞學檢查是一種安全快速且容易操作的技術，已經廣泛應用於頭頸部腫瘤的診斷，在腮腺腫瘤診斷方面，其特異診斷率 (specificity) 及準確率 (accuracy rate) 皆有很好的結果。
方法:臺中榮民總醫院耳鼻喉科及病理部自民國81年10月至86年10月共有120名於門診接受細針抽取細胞學檢查的腮腺腫瘤病人，其中89名後來接受手術治療，蒐集細針抽取細胞學與術後組織學結果統計後，比較其敏感率、特異診斷率及準確率。
結果:良性腫瘤有77名，惡性腫瘤有12名，細針抽取細胞學與術後組織學結果比較後，其特異診斷率為98.7%，感敏率為66.7%，準確率為94.3%。
結論:細針抽取細胞學檢查是一種安全，併發症少而且具有高診斷率的技術，在腮腺腫瘤病人方面，它可提供一個快速安全的手術前診斷，以利醫師手術前的計劃。

關鍵字

細針抽取細胞學 ； 腮腺腫瘤

並列摘要

Background: Fine-needle aspiration cytology is a safe, rapid, reliable and esay-to-perform office procedure. This technique has been widely applied to the diagnosis of head and neck tumors. In the evaluation of parotid tumors, it owns higt specificity and accuracy rates, compared with the histopathologic diagnosis.
Methods: From October 1992 to October 1997, there were 120 parotid tumor patients received fine-needle aspiration in our department. We used No. 23 needle attached to a 5 ml syringe to aspirate the masses. The aspirate was smeared on glass slides. Eighty-nine of them received surgery afterwards. We compared the cytologic diagnoses with the final histopatologic diagnoses in accuracy, specificity and sensitivity rates.
Results: Among 89 surgical patients, 56 of them were male, 33 were female. There were 77 patients with benign tumor: 36 pleomorphic adenomas, 32 warthin’s tumors, 5 monomorphic adenomas, and 4 sialoadenitis, and 12 patients with malignant tumor: 5 mucoepidermoid carcinomas, 3 acinic cell carcinomas, 3 adenoid cystic carcinomas, and 1 adenocarcinoma. There were 4 false-nega-tive. Two mucoepidermoid carcinomas diagnosed cytologically as warthin’s tumor and retention cyst separately. An aninic cell carcinoma diagnosed as oncocytoma and an adenoid cystic carcinoma diagnosed as a benign tumor. The false-negative rate was 4.5%. The accuracy of differentiation of benign versus malignant tumors was 94.3%. The sensitivity and the specificity for malignancy were 66.7% and 98.7%.
Conclusions: Fine-needle aspiration cytology is a rapid, accurate, cost-effective method in the evaluation of parotid tumors. It is a valuable adjunct to preoperative assessment and treatment planning in parotid tumor patients. With close cooperation between clinician and cytopathologist, the diagnostic rate of fine-needle aspiration in parotid tumors will be markedly improved in the future.

並列關鍵字

Fine-needle aspiration cytology ； parotid turmor