A comparison study of the reporting systems for salivary gland fine needle aspirations: Are they really different?

• Published in: Diagnostic cytopathology Vol. 46; no. 10; pp. 859 - 863
• Main Authors: Montezuma, Diana, Canberk, Sule, Aydın, Ozlem, Dermirhas, Mehmet Polat, Vieira, André F., Goksel, Süha, İnce, Ümit, Schmitt, Fernando
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.10.2018; Wiley Subscription Services, Inc; Wiley Blackwell (John Wiley & Sons)
• Subjects: Accuracy; Adolescent; Adult; Aged; Benign; Biopsy, Fine-Needle; Child; Cytology; Cytopathology; Demography; Female; fine needle aspiration; Humans; Immunity (Disease); Lesions; Male; Malignancy; Middle Aged; Milan system; Predictive Value of Tests; Reference Standards; reporting system; Research Report; Risk Factors; ROC Curve; Salivary gland; Salivary Gland Neoplasms - pathology; Salivary glands; Salivary Glands - pathology; Sensitivity and Specificity; Tumors; Young Adult; salivary gland; Milan system; cytology; fine needle aspiration; reporting system
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/dc.24037

Background Recently a new system for reporting salivary gland fine‐needle aspiration (FNA) cytology was proposed, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). Herein, we evaluated diagnostic accuracy of salivary gland FNA, comparing the system previously used in our hospital with the Milan system. Methods Salivary gland specimens obtained between 2011 and 2017 were reclassified according to MSRSGC. Risk of malignancy for each diagnostic category was determined. Diagnostic yield of both classifications was evaluated. Results The cases (n = 388) were classified according to the old system: nondiagnostic (n = 28), benign (n = 246), atypical (n = 36), neoplastic (n = 57), suspicious for malignancy (n = 7) and malignant (n = 14). The lesions were distributed according to the MSRSGC: nondiagnostic (n = 28), non‐neoplastic (n = 89), atypia of undetermined significance (n = 39), benign neoplasm (n = 156), neoplasm of uncertain malignant potential (n = 55), suspicious for malignancy (n = 7) and malignant (n = 14). When considering only benign and malignant cases, both classifications showed the same sensitivity (62.5%), specificity (100%) and similar accuracy (95.8%). Comparison between the two systems showed no significant difference. Conclusions Salivary gland FNA has high diagnostic accuracy and assists clinical management independently of the reporting system used, however, in some cases, the use of Milan system could be beneficial, since it allows an enhanced category stratification.