Ahmet DOBLAN, Ergun SEVİL, Togay MÜDERRİS, Muzaffer KIRIŞ

Tükürük Bezi Tümörü Tanısında Ultrasonografi (USG), Mangnetik Rezonans Görüntüleme (MRG), Bilgisayarlı Tomografi (BT), İnce İğne Aspirasyon Biyopsisi’nin (İİAB) Karşılaştırılması

Giriş: Tükürük bezleri tümörlerinde benign ve malign neoplazm arasındaki preoperatif farklılıkların belirlenmesi cerrahi operasyonun gerekliliği, aciliyeti ve kapsamını belirlemede önemlidir. Çalışmanın amacı, tükürük bezi kitlesi nedeniyle opere olmuş hastalarda, tükürük bezi tümörlerinin tanımlayıcı özelliklerinin ve tanı yöntemlerinin tanısal değerlerinin belirlenmesidir.Yöntemler: Çalışma, 2008-2016 yılları arasında, tükürük bezinde malign veya benign kitle nedeni ile opere edilen hastaların, tıbbi kayıtlarının retrospektif incelenmesi ile yapılan tanımlayıcı tipte bir araştırmadır. Hastalara preoperatif dönemde yapılan Ultrasonografi (USG), Magnetik Rezonans Görüntüleme (MRG), Bilgisayarlı Tomografi (BT), İnce İğne Aspirasyon Biyopsisi’nin (İİAB) sonuçları ve postoperatif dönemde histopatolojik tetkik sonuçları değerlendirildi. Kullanılan tanı yöntemlerinin sensitivite, spesifite, pozitif prediktif değer (PPD), negatif prediktif değer (NPD), eğri altında kalan alan (AUC±SE) değerlerinin hesaplanması için ROC analizi yapıldı.Bulgular: Çalışma grubu 114 kişiden oluşmakta olup yaş ortalamaları 46.90±14.32 yıl idi. Çalışma grubunun %54.4’ü erkek, %71.9’u 40 yaşın üstündeydi. Tükürük bezi tümörlerinin %71.9’u parotiste idi. Hastaların tanı amaçlı yapılan histopatoloji incelemesinde % 11.4’ünün malign tümöre sahip olduğu bulundu. Hastalarda en sık rastlanan benign tümör çeşidi pleomorfik adenom, en sık rastlanan malign tümör çeşidi mukoepidermoid kanser olarak saptandı. Sensitivite, NPD, AUC±SE değerlerinin en yüksek olduğu yöntem MRG, spesifite ve PPD değerlerinin en yüksek olduğu yöntem İİAB idi.Sonuç ve Öneriler: Sonuç olarak, hastalarda tükürük bezi tümörlerinin en sık parotis bezinde (%11.4’ü malign) görüldüğü, en sık benign tükürük bezi tümörünün pleomorfik adenom, en sık malign tükürük bezi tümörünün mukoepidermoid kanser olduğu bulundu. Sensitivite, NPD, AUC±SE değeri en yüksek olan yöntem MRG ve spesifite ve PPD değeri en yüksek olan yöntem İİAB idi. USG, BT, MRG, İİAB’nin tükürük bezi tümörlerindeki tanısal değerlerini inceleyen, daha geniş örneklemlerde yapılacak klinik araştırmaların faydalı olacağı düşünüldü.

Comparison of Ultrasonography (USG), Mangnetic Resonance Imaging (MRI), Computed Tomography (CT) and Fine Needle Aspiration Biopsy (FNAB) for the Diagnosis of Salivary Gland Tumor

Objective: The determination of preoperative differences between benign and malignant neoplasms in salivary gland tumors is important in determining the necessity, urgency and scope of surgical operation. The aim of this study was to determine the descriptive characteristics of salivary gland tumors and the diagnostic value of diagnostic methods in patients operated for salivary gland mass. Methods: The study is a descriptive study performed retrospectively with the medical records of patients operated for malignant or benign mass in salivary glands between 2008-2016. Preoperative Ultrasonography (US), Magnetic Resonance Imaging, Computed Tomography (CT), Fine Needle Aspiration Biopsy (FNAB) and postoperative histopathological results were evaluated. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) calculations were used for the used diagnostic methods and each was expressed as a percentage (%). Sensitivity, specificity, positive predictive value (PPD), negative predictive value (NPD), area under the curve±standard error (AUC ± SE) values of the diagnostic methods were used for ROC analysis. Results: The study group consisted of 114 individuals with a mean age of 46.90 ± 14.32 years. The most common localization of salivary gland tumors was parotid gland (71.9%). Histopathological examination of the patients for diagnostic purposes revealed that 11.4% had malignant tumors. Pleomorphic adenoma was the most common benign tumor and mucoepidermoid cancer was the most common malignant tumor. The highest sensitivity, NPD, AUC ± SE values were MRI and the method with the highest specificity and PPD was FNAB. Conclusion: In conclusion, it was found that salivary gland tumors were most commonly seen in the parotid gland (11.4% malignant), the most common benign salivary gland tumor was pleomorphic adenoma and the most common malignant salivary gland tumor was mucoepidermoid cancer. The method with the highest sensitivity, NPD, AUC ± SE values was MRI and the method with the highest specificity and PPD was FNAB. It was thought that clinical studies in larger samples that examined the diagnostic values of USG, CT, MRI, FNAB in salivary gland tumors would be beneficial.

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