涎腺腺样囊性癌细针吸取细胞学的鉴别诊断

腺样囊性癌在涎腺腺上皮恶性肿瘤中恶性程度位居第二,腭部2例,鼻腔3例,上颌窦1例。1.2方法穿刺前详细询问病史,仔细检查肿物位置、大小、硬度、活动度。穿刺时不需麻醉,对肿物皮肤进行常规消毒,左手固定肿物,右手持5ml一次性注射器,以45°角迅速刺入肿物,保持负压2ml多方位穿刺     

116例口服颌面颈部肿块细针吸取细胞学诊断分析

研究细针吸取细胞学检查对口腔颌部肿块的诊断价值。方法运用“友谊式细地穿刺器”对１１６例口腔颌面部颈部肿块进行ＦＮＡＣ检查,将其结果与肿块术后病理组织学诊断结果对比。结果：ＦＮＡＣ检查定性诊断的准确率为９０．５２％,误诊率 为９．４８％,假阳性仅１例;ＦＮＡＣ检查所定肿块组织类型与病理组织学诊断结果完全一致者达５０％;     

细针吸取细胞学检查在头颈部肿块诊断的应用(附429例报告)

细针吸取细胞学 (fine needle aspination cytolo-gy,FNA)检查是一种操作简便易行、创伤小、安全且诊断准确率高的诊断方法。因其可以术前了解肿块性质 ,为治疗方案提供参考或诊断诊据 ,渐为临床所接受的一种快速诊断方法。 1 987年在郑州召开的“细针吸取细胞学在病理诊断中的应用”为主题的全国会议 ,将 FNA正式定名为细针吸取细胞学 ,强调FNA为病理学的一个分支[1] ,对 FNA的应用和推广起了很大的推动作用。本文总结 1 8年来对 42 9例住院患者头颈部肿块 FNA检查的经验 ,并就有关问题作一讨论。1　材料和方法1 .1　材料选自 1 982…     

几种涎腺肿瘤的针吸细胞学诊断

我院1974—1983年经针吸细胞学诊断的涎腺肿瘤共计364例,计多形性腺瘤285例,腺淋巴瘤10例,眼样囊性癌26例,粘液表皮样癌37例,腺泡细胞癌6例。有组织切片对照的156例。本文对这些肿瘤的细胞学形态进行了描述,强调涎腺肿瘤的细胞学诊断必须重视具有特征性的粘液分布。对不具粘液的腺淋巴瘤注意嗜酸性细胞团或呈栅状排列的柱状细胞,腺泡细胞癌胞浆内常充满嗜硷性颗粒或有多数小空泡而成泡沫状。     

细针吸取活检对腮腺肿瘤的诊断价值

目的：探讨细针吸取活检对腮腺肿瘤的诊断价值。方法：68例非淋巴造血系统及非囊性病变的原发性腮腺肿瘤患者,术前行细针吸取细胞学检查,对40例良性的28例恶性肿瘤按不同组织来源分类;将穿吸结果与术后病理检查对照,按临床流行病学方法计算符合率,特异符合率,假阳性率和假阴性率。结果：细针吸取活检对良性或恶性肿瘤的诊断符合率无显著性差异（P＞0．05）;21例多形性腺瘤的符合率为100％,特异符合率为90．48％;8例非腺上皮来源良性肿瘤的符合率为50％,40例良性肿瘤的假阳性率为0,28例恶性肿瘤的假阴性率为17．86％,5例粘液表皮样癌中,4例报告倾向“多形性腺瘤”,结论：细针吸取活检对多形性腺瘤的诊断价值较大,对非腺上皮性良性肿瘤的诊断傺 大;粘液表皮样癌易误诊为多形性腺瘤。     

细针吸取细胞学检查对腮腺肿物的诊断价值

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。     

涎腺肿瘤的针吸细胞学诊断

涎腺肿瘤临床上常见,既往多以活组织检查确定其性质及手术范围,但不适宜对大涎腺肿块病变的诊断,针吸细胞学检查是一种简单、经济的诊断方法,现将我们应用针吸细胞学检查对65例涎腺肿瘤诊断,结合手术后组织学检查结果,分析如下: 1 材料与方法 1.1 材料:65例患者。男36例,女29例,年龄5-76岁,均为门诊或住院病人,因腮腺、颌下腺及     

涎腺肿瘤细针穿刺标本中端粒酶检测的临床意义

目的 研究细针穿刺检测涎腺肿瘤组织中细胞端粒酶活性的可行性，探讨端粒酶活性在涎腺肿瘤组织中的表达及意义。方法 采用聚合酶链式反应－端粒末端重复序列（PCR－TRAP）技术检测45例涎腺肿瘤细针穿刺标本中细胞的端粒酶。结果 33例良性肿瘤标本中3例端粒酶阳性，12例恶性肿瘤标本中10例端粒酶阳性。端粒酶活性检测与细胞学诊断符合率66.7%。二种方法同时应用可使确诊率提高至83.3%。结论 涎腺肿瘤组织细针穿刺标本端粒酶检测方法具备敏感性高、特异性好的特点，与细针穿刺细胞学检测技术联合应用，在涎腺肿瘤的诊断治疗、预后方面有十分广阔的应用前景。     

细针穿吸细胞学检查在腮腺区肿块诊断中的价值

目的评价细针穿吸细胞学检查(FNAC)在腮腺区肿块诊断中的应用价值。方法应用细针穿吸方法,对121例腮腺区肿块患者进行细胞学检查,其中男性62例,女性59例;年龄5～95岁,平均年龄57.88岁。将细胞学检查结果与术后组织病理和随访资料进行比较研究。结果FNAC的定性诊断准确率为92.56%(112/121),诊断准确率为89.26%。肿瘤的敏感性为91.25%,特异性为100%;7例患者为假阴性,假阴性率为8.75%;良、恶性病变的敏感性为70.97%,特异性为100%;9例患者为假阴性,假阴性率为29.03%,无假阳性患者。无临床并发症。结论FNAC在腮腺区肿块的诊断中有重要作用,是一种经济、快速、安全、并发症少见和诊断准确率高的细胞学诊断手段。     

Fine needle aspiration cytology of salivary gland lesions

247 salivary gland lesions were subjected to fine needle aspiration (FNA) cytology; 179 were designated as neoplastic lesions and 68 as non-neoplastic. Based on cytomorphologic features, the neoplastic and non-neoplastic lesions were subcategorised. All but 36 of the neoplastic lesions were subjected to histopathologic study. The overall diagnostic accuracy of FNA cytology for neoplastic lesions was 91%. The sensitivity rate for detecting malignant tumours was 87.8% and the specificity 98.0%. There was 100% sensitivity for cytodiagnosis of benign tumours. The high sensitivity and specificity of cytodiagnosis makes FNA cytology a valuable diagnostic modality in the evaluation of salivary gland lesions.     

Fine needle aspiration cytology (FNAC) of salivary gland tumours: Repeat aspiration provides further information in cases with an unclear initial cytological diagnosis

Introduction

Fine needle aspiration cytology (FNAC) for salivary gland tumours requires expertise in interpretation. When a diagnosis is not clear (despite a cellular aspirate), published work is lacking on the value of repeating the test.

Methods

A retrospective study of 135 patients who had FNAC followed by definitive excision for a suspected salivary gland tumour. Accuracy was compared among those requiring repeat FNAC on one more occasion because of a non-diagnostic initial cytology report.

Results

33 patients (24% of study group) had repeat FNAC. A definite cytological diagnosis was subsequently made in 27/33 patients (82%). The sensitivity (84%) and specificity (93%) of repeat FNAC in distinguishing benign from malignant tumours was similar to initial FNAC (70% and 95%, respectively).

Conclusions

Repeat FNAC may provide a cytological diagnosis in cases where the initial diagnosis is not clear, although cytology should be used in conjunction with other investigations of salivary tumours, including image-guided biopsy examination where appropriate. Ideally salivary gland FNAC should be interpreted by a specialist pathologist.     

涎腺肿瘤中端粒酶活性的检测及意义

目的 :探讨端粒酶活性在肿瘤诊断中的意义。方法 :采用非放射性同位素端粒酶重复扩增酶标法对2 9例涎腺肿瘤及 5例正常涎腺组织端粒酶活性进行检测 ,同时还对其中 5例涎腺肿瘤的细针穿刺细胞学检查标本进行了端粒酶活性检测。结果 :16例恶性涎腺肿瘤中 13例为端粒酶阳性 ,占本组恶性涎腺肿瘤的81% ,2例高分化粘液表皮样癌和 1例腺样囊性癌示端粒酶阴性。在 13例良性涎腺肿瘤中仅 1例端粒酶弱阳性。 5例正常涎腺组织端粒酶活性皆为阴性。 5例细针穿刺细胞学检查标本端粒酶活性检测显示 :3例恶性涎腺肿瘤中 2例端粒酶阳性 ,1例端粒酶阴性 ;2例良性涎腺肿瘤端粒酶阴性。结论 :把端粒酶作为新的肿瘤基因诊断的标志物是很有可能的     

Fine-needle aspiration cytology: a reliable tool in the diagnosis of salivary gland lesions

J Oral Pathol Med (2012) 41 : 106–112 Background: Fine‐needle aspiration cytology (FNAC) is used as the main initial diagnostic investigation for lumps in the head and neck region. Major salivary glands and some minor salivary glands are easily accessible; therefore, they are optimal targets for FNAC. The aim of this study was to discuss the advantages and pitfalls of FNAC as compared to histopathology in the salivary gland lesions. Material and methods: A total of 127 FNAC were carried out on salivary gland lesions from January 2006 to December 2010 – a 5‐year period. Histopathological follow‐up data were obtained in 56 cases. The study was conducted to examine the sensitivity, specificity, and accuracy of FNAC for salivary gland swellings in comparison with histopathology. Results: The male‐to‐female ratio was 2.4:1. Parotid gland was involved in 51.1%, submandibular gland in 37%, sublingual gland in 4.7%, and minor salivary glands in 7% of patients. There were 55.9% cases of non‐neoplastic lesions and 44.1% cases of neoplastic lesions on biopsy. Sensitivity, specificity, positive predictive value, and negative predictive value of FNAC for malignant neoplastic lesions were 84.61%, 86.48%, 68.75%, and 94.11%, respectively, whereas for benign neoplastic lesions, they were 84.61%, 91.66%, 91.6%, and 85%, respectively. Conclusion: Fine‐needle aspiration cytology is found to be a good sensitive and specific technique for the diagnosis of most of the salivary gland lesions. FNAC should be adopted as an initial investigation for all salivary gland swellings in conjunction with other investigations where appropriate.     

Utilisation of specialist sonographers for head and neck ultrasound fine-needle aspiration cytology can help shorten waiting lists and improve efficiency of the service

Head and neck ultrasonography with fine-needle aspiration cytology (FNAC) is recommended by the National Institute for Health and Care Excellence (NICE) and the British Association of Head and Neck Oncologists (BAHNO) for investigating neck masses. Finite specialist radiologists and increased demands on services have increased waiting lists and breached targets. Many patients are on a two-week cancer pathway and accurate investigation cannot be delayed. The implementation of a sonographer trained in neck ultrasound-guided FNAC was analysed together with its impact on the service. Over a 21-month period we have demonstrated a fall in waiting lists from 310 to 28 patients, without compromise to diagnostic accuracy. Additionally, a cost-saving of £60,000 was made. Improvements in efficiency and waiting lists can be achieved through targeted specialist training for allied health professionals, liberating specialists for other duties.     

CT灌注成像与细针穿刺细胞学检查在涎腺肿瘤诊断中的应用

目的:探讨CT灌注成像与细针穿刺细胞学检查对涎腺肿瘤良恶性的鉴别诊断价值.方法:36 例涎腺肿瘤(腮腺26 例,下颌下腺8 例,舌下腺1 例,腭部1 例)患者,术前均行细针穿刺细胞学检查和CT灌注扫描,并取得相应的灌注参数:血流量(blood flow,BF),血容量(blood volume,BV),平均通过时间(mean transit time,MTT)和表面渗透性(permeability surface,PS),所有涎腺肿瘤术后均行病理检查.结果: 36 例患者中,最终病理确诊为涎腺恶性肿瘤者13 例,细针穿刺细胞学检查对恶性肿瘤检测的敏感性为84.6 %(11/13),特异性为95.7% (22/23),符合率为91.7%(33/36).CT灌注成像恶性肿瘤组BF、BV、PS值均高于良性肿瘤组(P<0.05),而2 组之间的MTT参数则无统计学差异(P>0.05).其诊断恶性肿瘤的敏感性为92.3%(12/13),特异性为86.9%(20/23),符合率为88.9%(32/36).细针穿刺细胞学检查假阴性的涎腺恶性肿瘤可通过CT灌注成像检查得到正确诊断.结论:CT灌注成像能提供涎腺肿瘤微循环灌注方面的信息,有利于肿瘤良恶性的鉴别,与细针穿刺细胞学检查并联应用,能够明显提高涎腺肿瘤诊断的准确性.     

The accuracy of fine needle aspiration cytology in the clinical diagnosis of minor salivary gland tumours

The objective of this study was to investigate the accuracy of fine needle aspiration cytology (FNAC) and biopsy for the clinical diagnosis of minor salivary gland tumours (MSGTs). This retrospective study of 32 MSGT cases was conducted over a 5-year period. Clinical features including age, sex, and location of the tumour were obtained from the patient clinical records. All cases were also assessed histologically according to the 2017 World Health Organization Classification of Head and Neck Tumours. The results of FNAC and biopsy were correlated with those of histopathology, and their sensitivity, specificity, and diagnostic efficacy were calculated using histopathology as the gold standard. Eighteen malignant MSGTs (56.3%) and 14 benign MSGTs (43.8%) were diagnosed by pathological diagnosis. The most common malignant tumour was mucoepidermoid carcinoma (seven cases, 38.9%). Most benign cases were pleomorphic adenomas (13 cases, 92.9%). FNAC was performed for 23 cases and biopsy for 13 cases. The sensitivity and specificity of FNAC were 66.7% and 91.0%, respectively, while those of biopsy were 90.0% and 100.0%, respectively. Although FNAC is a minimally invasive and cost-effective procedure, it is less accurate than biopsy in the assessment of MSGTs. Repeated FNAC or biopsy should be considered in negative and unsatisfactory FNAC cases.     

复发性涎腺多形性腺瘤的临床与病理分析

目的 探讨复发性涎腺多形性腺瘤(recurrent pleomorphic adenoma,RPA)的临床与病理特点.方法 1962～2002年间在我院因涎腺RPA住院手术治疗的患者121例,对其中随诊10年以上的38例患者进行临床与病理分析.结果 腮腺、颌下腺及腭腺最多,复发次数分别为6、12、4次.单发14例,多发24例.腮腺及腭腺复发肿瘤除原手术野、手术切口瘢痕处外,6例多次复发后向腮腺深叶、咽旁及颅底扩展.34例中,病理类型以粘液成分为主型4例,细胞密集型13例,混合型17例.结论 结合病理研究,肿瘤复发的主要原因是残留瘤芽及术中肿瘤包膜破裂种植.复发肿瘤位置表浅、单发者可手术局部摘除,多发、位置深在者需行解剖面神经的肿瘤摘除术.避免涎腺多形性腺瘤术后复发的关键是第一次手术的术式,防止肿瘤包膜破裂并严格遵守无瘤手术原则.     

儿童涎腺上皮性肿瘤的临床研究

目的：探讨儿童涎腺上皮性肿瘤的发病特点及诊疗要点。方法：对４５例经病理证实的１６ 岁以下儿童涎腺上皮性肿瘤患者的临床资料进行统计分析。结果：儿童涎腺上皮性肿瘤,男女之比为１．１４：１;发病平均年龄为１０．３４岁,随着年龄的增大,患病比随之增高,但年龄越小患恶性肿瘤的可能性愈大,且恶性程度愈高;发病部位以腮腺、颌下腺及腭部多见,大小涎腺间良恶性肿瘤患病比无明显差别;良性肿瘤以多形性腺瘤常见,恶性肿瘤以粘液表皮样癌最常见。良性肿瘤术后少有复发,恶性肿瘤复发率约占被随访者的５０％ 。结论：对儿童涎腺上皮性肿瘤,尤其是患儿年龄愈小时,患恶性肿瘤的可能性更大,应引起高度警惕。恶性肿瘤手术应彻底,不可因患儿年龄小过分强调保留面神经而增加复发的机会。