Salivary Gland Neoplasm of Uncertain Malignant Potential (SUMP) (Milan IVB) and Its Subgroups: A Multi-Institutional Analysis of Risk of Neoplasm and Malignancy

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY Diagnostic Cytopathology Pub Date : 2024-08-20 DOI:10.1002/dc.25394

Rong Xia, Issa Hindi, Deepika Savant, Samer Khader, Sigfred Lajara, Brendan Belovarac, Kasturi Das, Karen Chau, Mohammed Abdelwahed, Amr Ali, Oliver Szeto, Osvaldo Hernandez, Wei Sun, Cheng Z. Liu, Fang Zhou, Aylin Simsir, Tamar C. Brandler

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Abstract

Objectives

Fine needle aspiration (FNA) plays a crucial role in their initial assessment of salivary gland neoplasms. In the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC), the category of Salivary Gland Neoplasm of Uncertain Malignant Potential (SUMP) categorizes lesions with ambiguous features. This study aims to investigate the risk of neoplasm (RON) and risk of malignancy (ROM) within different subgroups of SUMP lesions using data from three large academic institutions.

Methods

We analyzed salivary gland (FNA) cases from three academic institutions post-MSRSGC implementation. Salivary gland FNA cases categorized as Milan IVB (SUMP) with subsequent surgical pathology follow-up were analyzed. Cases were divided into basaloid, oncocytic, and clear cell SUMP subtypes, with RON and ROM assessed and compared.

Results

Out of 1377 MSRSGC cases, 231 were SUMP (16.8%), with 101 subjected to surgical pathology follow-up. The overall ROM for SUMP was 20.8%, with variations of 10% to 29.5% observed amongst institutions, but no significant difference was observed among three institutions (p = 0.15). Basaloid and oncocytic SUMP displayed 17.1% and 20.5% ROM, respectively, without significant disparity. However, all clear cell SUMP cases were malignant on surgical resection.

Conclusions

This study highlights the variability in ROM for SUMP lesions and the significantly higher ROM in SUMP cases with clear cell features. These findings emphasize the importance of accurately subcategorizing SUMP lesions, particularly those with clear cell features, for appropriate clinical management.

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恶性潜能不确定的唾液腺肿瘤（SUMP）（米兰 IVB）及其亚组：肿瘤和恶性肿瘤风险的多机构分析。

目的：细针穿刺术（FNA）在唾液腺肿瘤的初步评估中起着至关重要的作用。在米兰唾液腺细胞病理学报告系统（MSRSGC）中，恶性潜能不确定的唾液腺肿瘤（SUMP）类别将特征不明确的病变归为一类。本研究旨在利用三所大型学术机构的数据，调查不同亚组 SUMP 病变的肿瘤风险（RON）和恶性风险（ROM）：我们分析了三个学术机构在实施MSRSGC后的唾液腺（FNA）病例。我们分析了被归类为米兰 IVB（SUMP）的唾液腺 FNA 病例，并进行了后续手术病理随访。病例被分为基底细胞型、肿瘤细胞型和透明细胞型 SUMP 亚型，并对 RON 和 ROM 进行了评估和比较：结果：在1377例MSRSGC病例中，231例为SUMP（16.8%），其中101例进行了手术病理随访。SUMP的总体ROM为20.8%，各机构之间的差异在10%至29.5%之间，但三家机构之间无明显差异（P = 0.15）。基底细胞和肿瘤细胞SUMP的ROM分别为17.1%和20.5%，无明显差异。然而，所有透明细胞 SUMP 病例在手术切除时均为恶性：本研究强调了SUMP病变ROM的可变性，以及具有透明细胞特征的SUMP病例ROM明显较高。这些发现强调了对 SUMP 病变，尤其是具有透明细胞特征的 SUMP 病变进行准确分类以进行适当临床管理的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.