A novel clinically-oriented classification of fine-needle aspiration cytology for salivary gland tumors: a 20-year retro
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ORIGINAL ARTICLE
A novel clinically‑oriented classification of fine‑needle aspiration cytology for salivary gland tumors: a 20‑year retrospective analysis of 1175 patients Masataka Taniuchi1 · Ryo Kawata1 · Shuji Omura1 · Shin‑ Ichi Haginomori1 · Tetsuya Terada1 · Masaaki Higashino1 · Yoshitaka Kurisu2 · Yoshinobu Hirose2 Received: 20 July 2020 / Accepted: 15 October 2020 © The Author(s) 2020
Abstract Background When determining treatment strategy for a salivary gland tumor, assessing histology and malignancy grade before surgery is essential. Several new diagnostic classification systems for salivary gland cytology have recently been proposed. However, none incorporate histology and grade of malignancy. Methods We developed a new cytology classification system that incorporates histology and grade of malignancy of salivary gland tumors (OMC classification), consisting of 11 categories. Our OMC classification was applied to 1175 patients who had preoperative cytology and confirmed final pathological diagnosis available from the past 20 years at our hospital (benign tumor: 981 patients, malignant tumor: 194 patients). Results Based on the cytology, 729 patients (62.0%) had benign histology (Category 4–1), and 87 patients (7.4%) were diagnosed with grade of malignancy (Category 6–3 + 6–4). Based on the final pathological diagnosis, the accuracy rate of Category 4–1 and Category 6–3 + 6–4 of our classification system was 93.4% and 88.5%, respectively. Conclusion Based on the correct diagnosis rate, the inclusion of histology and grade of malignancy in the salivary gland cytology classification was considered feasible. Thus, the OMC classification system is considered a useful tool when determining the treatment strategy for a salivary gland tumor. Keywords Classification · Fine-needle aspiration · Cytopathology · Parotid tumor · Histological grade
Introduction Fine-needle aspiration cytology (FNAC) is a well-established procedure for the diagnosis of salivary gland tumors. Preoperative diagnosis with FNAC can help determine the extent of required resection, the planning for neck dissection, and the preservation of the facial nerve, as well as help in counseling patients with a parotid tumor [1, 2]. Moreover, this is particularly important because the management of parotid lesions depends on whether the tumor is benign or * Ryo Kawata oto034@osaka‑med.ac.jp 1
Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical College, 2‑7 Daigaku‑Machi, Takatsuki, Osaka 569‑8686, Japan
Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan
2
malignant, the histological type, and the histological grade of malignancy.[3]. Therefore, even if a surgical procedure is considered appropriate, the histology and grade of malignancy should be obtained before the initial operation, especially in the case of malignant tumors. The Bethesda system for reporting thyroid cytopathology is commonly used for cytology reporting of thyroid glands [4]. Recently, a group of international pathologists
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