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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >The role of indeterminate fine-needle biopsy in the diagnosis of parotid malignancy
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The role of indeterminate fine-needle biopsy in the diagnosis of parotid malignancy

机译：不确定性细针穿刺活检在腮腺恶性肿瘤诊断中的作用

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Objectives/Hypothesis To examine the significance of indeterminate fine needle aspiration biopsy in the diagnosis of parotid gland malignancy. Study Design Retrospective case series, academic tertiary referral center. Methods A total of 559 parotidectomies performed between the years of 2005 and 2010 were reviewed, with 56.7% (N = 317) meeting investigation eligibility criteria: primary parotid tumor, availability of fine-needle aspiration biopsy, intraoperative frozen section, and final pathologic diagnosis. One-hundred fifteen (n = 115, 36.3%) of the 317 parotid biopsies were interpreted as indeterminate. Clinical history, physical examination, operative findings, and histopathologic characteristics were analyzed. Multiple logistic regression, with deviation from means coding, was used to estimate the odds of malignancy in the indeterminate group and provide a comparison with reference to the average odds of malignancy over the overall sample. Results Overall final pathologic distribution of parotid masses (N = 317) was 82.3% benign and 17.7% malignant. Overall final pathologic distribution of parotid masses in the indeterminate group (n = 115) was 31.3% malignant and 68.7% benign. In comparison, the overall group (N = 317) had a decreased comparative percentage of malignant specimens at 17.7%. Interestingly, in the instance of an indeterminate biopsy, the odds of having a malignancy was estimated to increase by 1.98-fold compared to overall mean odds of malignancy in the sample. Other statistically significant clinical predictors of parotid malignancy included history of prior malignancy, current tobacco user, locally invasive characteristics intraoperatively, and facial nerve involvement intraoperatively. Conclusions In the context of an indeterminate fine-needle aspiration biopsy, an elevated index of suspicion for parotid malignancy may be warranted.
机译：目的/假设探讨不确定的细针穿刺活检在腮腺恶性肿瘤诊断中的意义。研究设计回顾性案例系列，大学高等教育转诊中心。方法对2005年至2010年间进行的559例腮腺切除术进行回顾，其中56.7％（N = 317）符合调查资格标准：腮腺原发性肿瘤，细针穿刺活检，术中冰冻切片和最终病理诊断。 317例腮腺活检中有一百十五（n = 115，36.3％）被解释为不确定。分析临床病史，体格检查，手术结果和组织病理学特征。采用多元逻辑回归分析（均值编码有所偏差）来估计不确定组中的恶性肿瘤几率，并比较整个样本中恶性肿瘤的平均几率。结果腮腺肿块的总体最终病理分布（N = 317）为良性的82.3％，恶性的17.7％。不确定组（n = 115）腮腺肿块的总体最终病理分布为恶性31.3％，良性68.7％。相比之下，整个组（N = 317）恶性标本的相对百分比降低了17.7％。有趣的是，在活检不确定的情况下，与样本中恶性肿瘤的总体平均机率相比，恶性肿瘤的机率估计增加了1.98倍。腮腺恶性肿瘤的其他具有统计学意义的临床预测因素包括既往恶性肿瘤的病史，当前吸烟者，术中局部侵袭性特征以及术中面神经受累。结论在不确定的细针穿刺活检的情况下，可能需要提高腮腺恶性肿瘤的怀疑指数。

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