R. MAHMUDOVA, S. AKYILDIZ, R MİDİLLİ, Ü. ULUÖZ, A. YAVUZER

Parotis kitlelerinde ince iğne aspirasyon biyopsisinin tanısal değeri

Amaç: Parotis kitlelerinin tanısında ince iğne aspirasyon biyopsisi (İİAB)'nin değerini ve doğruluğunu belirlemek amaçlanmıştır. Yöntem ve Gereç: Ege Üniversitesi Kulak Burun Boğaz Anabilim Dalında 2005-2009 yılları arasında, parotiste kitle nedeniyle opere edilen hastalar içinde operasyon öncesi İİAB yapılan 44 hastanın verileri retrospektif olarak incelendi. İİAB biyopsisinin tanısal değeri operasyon sonrası piyesin histopatolojik sonuçları ile karşılaştırılarak incelendi. Bulgular: Hastaların 33'ü erkek (%75), 11'i kadın (%25) olup yaş ortalaması 54 (yaş aralığı: 7-89) idi. İİAB, 44 hastanın 6'sında non-diagnostik olarak bildirildi (%14). Kalan 38 hastanın 28'inde İİAB benign olarak rapor edildi (%74). Bunların 25 tanesi postoperatif histopatolojide benign kitle olarak doğrulandı (%89). İİAB de malign olarak bildirilen 10 olgunun ise postoperatif olarak 8'i doğrulandı (%80). Buna göre malign olguları saptamada İİAB'nin sensitivitesi %73, spesifisitesi %93, pozitif prediktif değeri %80, negatif prediktif değeri %89 ve toplam doğruluk oranı %87 olarak saptandı. İİAB'de 13 olguda spesifik histopatolojik tanı öngörüldü ve bunların 11'i postoperatif doğrulandı. Toplamda İİAB %29 oranında da direkt histopatolojik tanıyı verebilmiştir. Sonuç: İİAB, parotid kitlelerin preoperatif değerlendirilmesinde değerli ve güvenilir bir yardımcı yöntemdir.

Diagnostic value of fine needle aspiration biopsy in parotid masses

Aim: The aim of this study is to determine the value and accuracy of fine needle aspiration biopsy (FNAB) in diagnosis of parotid masses. Material and Methods: Data from patients who were operated on between 2005 and 2009 for parotid masses at Ege University Otolaryngology Department and who underwent (N=44) preoperative FNAB was analyzed retrospectively. The diagnostic value of the FNAB was determined by comparing the results with the postoperative histopathologic reports. Results: Thirty-three of the patients were male (75%) and eleven were female (25%) with a mean age of 54 (range: 7-89). FNAB was non-diagnostic in 6 of the 44 patients (14%). Twenty-eight of the remaining 38 patients were reported as benign (74%). Twenty-five of these (89%) were confirmed by postoperative histopathology. Of the 10 patients who were reported as malignant by FNAB, eight of them were confirmed postoperatively (80%). The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of FNAB in determining malignant disease was calculated as 73%, 93%, 80%, 89% and 87% respectively. The specific histopathologic diagnosis was predicted in 13 patients and 11 of them were confirmed postoperatively. FNAB was able to correctly determine the final histopathologic diagnosis in 29% of the patients. Conclusion: FNAB was found to be a valuable and reliable adjunctive method in preoperative evaluation of parotid masses.

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1) Tandon S, Shahab R, Benton JI, et al. Fine-needle aspiration cytology in a regional head and neck cancer center: comparison with a systematic review and meta-analysis. Head Neck 2008;30:1246-1252.
2) Zbären P, Schär C, Hotz MA, Loosli H. Value of fine-needle aspiration cytology in parotid gland masses. Laryngoscope 2001;111:1989-1992.
3) Gross M, Ben-Yaacov A, Rund D, Elidan J. Role of open incisional biopsy in parotid tumors. Acta Otolaryngol 2004;124:758-760.
4) Cohen EG, Patel SG, Lin O, et al. Fine-needle aspiration biopsy of salivary gland lesions in a selected patient population. Arch Otolaryngol Head Neck Surg 2004;130:773-778.
5) Satar B, Gerek M, Yetişer S, ve ark. Majör Tükrük Bezi Tümörleri: 93 Olgunun Analizi. Turkiye Klinikleri J E.N.T. 2001;1:123-128.
6) Guyot JP, Obradovic D, Krayenbuhl M, et al. Fine-needle aspiration in the diagnosis of head and neck growths: is it necessary? Otolaryngol Head Neck Surg 1990;103:697-701.
7) Frable MA, Frable WJ. Fine-needle aspiration biopsy of salivary glands. Laryngoscope 1991;101;245-249.
8) Cohen MB, Ljung BM, Boles R. Salivary gland tumors. Fine needle aspiration vs frozen section diagnosis. Arch Otolaryngol Head Neck Surg 1986;112:867-869.
9) Zurrida S, Alasio L, Tradati N, et al. Fine-needle aspiration of parotid masses. Cancer 1993;72:2306-2311.
10) Al-Khafaji BM, Nestok BR, Katz LR. Fine-needle aspiration of 154 parotid masses with histologic correlation: ten-year experience at the University of Texas M. D. Anderson Cancer Center. Cancer 1998;84:153-159.
11) Pitts DB, Hilsinger RL, Karandy E, et al. Fine-needle aspiration in the diagnosis of salivary gland disorders in the community hospital setting. Arch Otolaryngol Head Neck Surg 1992;118:479-482.