3种辅助检查诊断涎腺肿瘤符合率的比较研究
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摘要
目的通过研究口腔涎腺肿瘤不同检查的诊断符合率,为临床提供术前快速、简便、有效、低成本的诊断方法。方法回顾性分析274例常见涎腺肿瘤B超检查、细针吸取细胞学和术中冷冻切片镜检,并与术后组织病理学检查进行对比。结果①B超与石蜡切片对比总的定性诊断符合率为83.2%,其中良性肿瘤的诊断符合率为85.2%,恶性肿瘤符合率为73.3%。②细针吸取细胞学与石蜡切片对比总的定性诊断符合率为87.0%,其中良性肿瘤为88.6%,恶性肿瘤为79.2%;明确诊断总的符合率为63.8%,其中良性肿瘤为64.0%,恶性肿瘤为62.5%。③冷冻切片与石蜡切片对比总的定性诊断符合率为94.9%,其中良性肿瘤为97.4%,恶性肿瘤为83.0%。结论术中冷冻切片对于涎腺肿瘤的诊断符合率较细针吸取细胞学及B超检查的符合率高,但细针吸取细胞学与B超在术前诊断和治疗计划中有很好的辅助作用。
Objective To investigate the diagnostic accuracy of B-ultrasonography, fine needle aspiration biopsy, and peri-surgical frozen section biopsy in oral salivary glands tumors. Methods Totally 274 cases with salivary gland tumors were involved in this study. B-ultrasonography, fine needle aspiration biopsy and peri-surgical frozen section biopsy were performed in all patients. Diagnostic accuracy of the tools was confirmed with the postoperative histopathological examination. Result The total qualitative diagnostic accuracy of B-ultrasonography was 83.2%, of which the benign tumor and malignant tumor was 85.2% and 73.3%, respectively. The total qualitative diagnostic accuracy of fine needle aspiration biopsy was 87.0%, of which the benign tumor and malignant tumor was88.6% and 79.2%, respectively. The definite diagnosis rate was 63.8%, of which the benign tumor and malignant tumor was 64.0% and 62.5%, respectively. The total qualitative diagnostic accuracy of peri-surgical frozen section biopsy was 94.9%, of which the benign tumor and malignant tumor was 97.4% and 83.0%, respectively. Conclusions Diagnostic accuracy of peri-surgical frozen section biopsy is satisfactory while the fine needle aspiration biopsy and B-ultrasonography are good pre-surgical diagnostic tools.
Objective To investigate the diagnostic accuracy of B-ultrasonography, fine needle aspiration biopsy, and peri-surgical frozen section biopsy in oral salivary glands tumors. Methods Totally 274 cases with salivary gland tumors were involved in this study. B-ultrasonography, fine needle aspiration biopsy and peri-surgical frozen section biopsy were performed in all patients. Diagnostic accuracy of the tools was confirmed with the postoperative histopathological examination. Result The total qualitative diagnostic accuracy of B-ultrasonography was 83.2%, of which the benign tumor and malignant tumor was 85.2% and 73.3%, respectively. The total qualitative diagnostic accuracy of fine needle aspiration biopsy was 87.0%, of which the benign tumor and malignant tumor was88.6% and 79.2%, respectively. The definite diagnosis rate was 63.8%, of which the benign tumor and malignant tumor was 64.0% and 62.5%, respectively. The total qualitative diagnostic accuracy of peri-surgical frozen section biopsy was 94.9%, of which the benign tumor and malignant tumor was 97.4% and 83.0%, respectively. Conclusions Diagnostic accuracy of peri-surgical frozen section biopsy is satisfactory while the fine needle aspiration biopsy and B-ultrasonography are good pre-surgical diagnostic tools.
引文
[1]刘华,李龙江,温玉明,等.涎腺肿瘤3461例临床病例分析[J].实用口腔医学杂志,2004,20(4):475-477.
[2]毛广文,袁荣涛,贾暮云,等.20年间2187例涎腺肿瘤临床分析[J].齐鲁医学杂志,2017(1):20-22.
[3]张素花,方庆全,陈宏.超声引导下细针穿刺制作细胞块术前诊断涎腺恶性肿瘤的应用价值[J].中国超声医学杂志,2017(5):385-387.
[4]何秋香,陈建欧,徐纪为.涎腺上皮性肿瘤针吸细胞学检查[J].中国肿瘤临床,2005,32(4):212-213.
[5]ZHANG S,BAGBY J,BAO R,et al.Fine-needle aspiration of salivary glands:five-year experience from a single academic center[J].Cancer,2008,114(5):442-443.
[6]HUQ A H,AKTARUZZAMAN M,HABIB M A,et al.Acomparative study between fine needle aspiration cytology findings and histopathological report of major salivary gland neoplasm in a tertiary hospital of Bangladesh[J].Bangladesh Medical Research Council Bulletin,2013,39(2):69-73.
[7]赵利,朱立强.细针吸取细胞学对涎腺上皮性肿瘤的诊断价值[J].临床与实验病理学杂志,2015,31(11):1284-1286.
[8]KEITH S H.The accuracy of clinical examination versus frozen section in the diagnosis of parotid masses[J].Journal of Oral&Maxillofacial Surgery,1997,55(1):29-31.
[9]BARNES L.Surgical pathology of the head and neck[M].3rd ed.New York:Informa Healthcare,2008:475-648.
[10]田臻.涎腺肿瘤冰冻切片诊断[J].中国实用口腔科杂志,2011,4(4):217-220.
[11]孙沫逸,郑军.涎腺肿瘤的诊断[J].中国实用口腔科杂志,2008,1(3):135-138.
[2]毛广文,袁荣涛,贾暮云,等.20年间2187例涎腺肿瘤临床分析[J].齐鲁医学杂志,2017(1):20-22.
[3]张素花,方庆全,陈宏.超声引导下细针穿刺制作细胞块术前诊断涎腺恶性肿瘤的应用价值[J].中国超声医学杂志,2017(5):385-387.
[4]何秋香,陈建欧,徐纪为.涎腺上皮性肿瘤针吸细胞学检查[J].中国肿瘤临床,2005,32(4):212-213.
[5]ZHANG S,BAGBY J,BAO R,et al.Fine-needle aspiration of salivary glands:five-year experience from a single academic center[J].Cancer,2008,114(5):442-443.
[6]HUQ A H,AKTARUZZAMAN M,HABIB M A,et al.Acomparative study between fine needle aspiration cytology findings and histopathological report of major salivary gland neoplasm in a tertiary hospital of Bangladesh[J].Bangladesh Medical Research Council Bulletin,2013,39(2):69-73.
[7]赵利,朱立强.细针吸取细胞学对涎腺上皮性肿瘤的诊断价值[J].临床与实验病理学杂志,2015,31(11):1284-1286.
[8]KEITH S H.The accuracy of clinical examination versus frozen section in the diagnosis of parotid masses[J].Journal of Oral&Maxillofacial Surgery,1997,55(1):29-31.
[9]BARNES L.Surgical pathology of the head and neck[M].3rd ed.New York:Informa Healthcare,2008:475-648.
[10]田臻.涎腺肿瘤冰冻切片诊断[J].中国实用口腔科杂志,2011,4(4):217-220.
[11]孙沫逸,郑军.涎腺肿瘤的诊断[J].中国实用口腔科杂志,2008,1(3):135-138.