Citološka dijagnoza tumora velikih žlijezda slinovnica (FNAC) = Fine Needle Aspiration Cytology (FNAC) in diagnosis of salivary gland tumours / Ante Jakšić, Christophe Štemberger, Gordana Zamolo, Andrea Dekanić, Robert Cerović, Margita Belušić-Gobić.
Sažetak

Cilj: Tumori žlijezda slinovnica su rijetke neoplazme glave i vrata, no histološki čine vrlo heterogenu skupinu tumora. Važna metoda njihove dijagnostike je ultrazvučna pretraga žlijezda slinovnica uz citopunkciju tumorske promjene. Cilj rada je odrediti učestalost pojedine vrste tumora, specifičnost i senzitivnost citološkog nalaza te utvrditi stupanj podudarnosti između citološkog i patohistološkog nalaza. Ispitanici i metode: Ovim istraživanjem obuhvaćeno je 49 pacijenata operiranih zbog tumora velikih žlijezda slinovnica između 2015. i 2017. godine. Uključeni su samo pacijenti s prijeoperativnim citološkim nalazom i postoperativnim patohistološkim nalazom koji su međusobno uspoređeni. Rezultati: Najzastupljenija skupina pacijenata je ona iznad 60 godina (57 %). Doušna žlijezda bila je najčešće sijelo tumora u 94 % pacijenata. Prema citološkom nalazu dijagnosticirano je 40 dobroćudnih i 9 zloćudnih tumora. Patohistološkom analizom utvrđeno je 39 dobroćudnih i 10 zloćudnih tumora. Najčešće patohistološke dijagnoze bile su Warthinov tumor (cistadenolimfom) u 52,5 % i pleomorfni adenom u 37,5 % pacijenata. Senzitivnost citološkog nalaza iznosila je 90 %, dok je specifičnost bila 100 %. Kappa (κ) koeficijent bio je 0,93 (95 % CI = 0.687 – 0.979). Zaključak: U ovoj studiji citološka punkcija i analiza pokazala se kao vrlo dobra metoda u dijagnostici tumora velikih žlijezda slinovnica s visokom osjetljivošću i specifičnošću te izvrsnim stupnjem podudarnosti između citološkog nalaza i krajnje dijagnoze.; Aim: Salivary gland tumours are rare head and neck neoplasms that histologically make up a very heterogeneous tumour group. The most important diagnostic method is an ultrasound exam of the salivary gland with cytopunction of a tumour. The aim of the paper is to determine the specificity and sensitivity of the cytological findings and to determine the degree of agreement between the cytological and histopathological findings. Patients and methods: This study encompassed 49 patients who underwent surgery due to salivary gland tumors between 2015-2017. Only patients with preoperative cytologic findings and postoperative histopathological findings were compared. Results: The most frequent group of patients were those over 60 years (57%). The salivary gland was the most common cancer site in 94% of patients. According to the cytological finding, 40 benign and 9 malignant tumours were diagnosed. In the histopathological study of lesions, 39 were diagnosed as benign and 10 as malignant. The most common histopathological diagnosis was Warthin’s tumor (cystenolymphoma) in 52.5% and pleomorphic adenom in 37.5% of patients. Based on the data, sensitivity was 90% and specificity was 100%. Kappa statistics for the degree of agreement between fine needle aspiration cytology and histological results were 0.93 (95% CI = 0.687-0.979). Conclusion: In our study, FNAC proved to be a very good method in the diagnosis of salivary gland tumours with high sensitivity and specificity, and excellent degree of agreement between FNAC and final diagnosis.