Usage of Milan System in Risk Stratification of Submandibular Gland Fine Needle Aspiration Cytology

IF 2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2025-01-24 DOI:10.1002/lary.32019

Wan Xin Yew MBBS, Kevin C.C. Choy FAMS, Manish M. Bundele FRCPath, Ernest W. Fu FAMS, Hao Li FAMS, Ming Yann Lim FAMS, Yijin Jereme Gan FAMS

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Abstract

Objectives

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) categorizes fine needle aspiration and cytology (FNAC) results into 6 tiers and assigns a risk of malignancy (ROM) to each category. Its utility in submandibular gland lesions remains unclear. Our article aims to study (1) the utility of the MSRSGC in classifying FNAC of submandibular gland masses, (2) describe the demographics and incidence of submandibular gland malignancy in our population, and (3) analyze the accuracy of FNAC in diagnosis of benign and malignant submandibular gland tumors.

Methods

In this retrospective case series, the FNAC results of 92 patients who underwent pre-operative FNAC and excision of submandibular gland between May 2008 and December 2023 were reviewed and assigned to a MSRSGC category, and ROM was calculated based on histological diagnosis.

Results

20/92 (21.7%) submandibular gland excisions with pre-operative FNAC were malignant. ROM is as follows: non-diagnostic 7.1%, non-neoplastic 12.5%, atypia of undetermined significance 35.3%, benign neoplasm 3.3%, salivary gland neoplasm of uncertain malignant potential 35%, suspicious for malignancy 100%, and malignant 100%.

Conclusion

Our study validates the usage of the MSRSGC in the work up of submandibular gland tumors.

Level of Evidence

4 Laryngoscope, 135:2392–2398, 2025

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米兰系统在颌下腺细针抽吸细胞学风险分层中的应用。

目的：米兰唾液腺细胞病理学报告系统（MSRSGC）将细针抽吸和细胞学（FNAC）结果分为6级，并为每个类别分配恶性风险（ROM）。其在颌下腺病变中的应用尚不清楚。我们的文章旨在研究(1)MSRSGC在颌下腺肿块FNAC分类中的应用，(2)描述我国人群中颌下腺恶性肿瘤的人口统计学和发病率，(3)分析FNAC在颌下腺良恶性肿瘤诊断中的准确性。方法：回顾性分析2008年5月至2023年12月间92例术前行FNAC及颌下腺切除术患者的FNAC结果，并将其划分为MSRSGC分类，根据组织学诊断计算ROM。结果：20/92（21.7%）术前颌下腺FNAC切除术为恶性。ROM：非诊断性7.1%，非肿瘤性12.5%，不确定意义的异型性35.3%，良性肿瘤3.3%，恶性潜能不确定的唾液腺肿瘤35%，疑似恶性100%，恶性100%。结论：本研究验证了MSRSGC在颌下腺肿瘤诊断中的应用。证据等级：4喉镜，2025。

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects