Validnost minimalno invazivnih dijagnostičkih procedura tumorskih promena pljuvačnih žlezda-Core needl biopsio

Abstract

Uvod/cilj. Dijagnoza tumora pljuvačnih žlezda se pretežno zasniva na radiološkom ispitivanju i histološkoj analizi patološke mase dobijene biopsijom. Cilj ove studije je bio da se ispitaju specifičnost, senzitivnost i tačnost biopsije šupljom iglom u dijagnozi pacijenata sa oboljenjima parotidne i submandibularne pljuvačne žlezde. Metode. Istraživanje je sprovedeno kao prospektivna klinička studija koja je obavljena između maja 2008.- me godine i maja 2016.- te godine u Odeljenju za otorinolaringologiju i maksilofacijalnu hirurgiju Kliničkog centra Zemun, Beograd. U studiji je obuhvaćeno 200 pacijenta od kojih je kod 100 bilo dijagnostikovano prisustvo tumora u doušnoj pljuvačnoj žlezdi i 100 pacijenata kod kojih je bilo dijagnostikovano prisustvo tumora u podviličnoj pljuvačnoj žlezdi. Biopsija šupljom iglom je bila sprovedena kod svih pacijenata kod kojih je tumor bio manji od 2 centimetara, koji je bio udaljen od krvnih sudova i udaljen od dubokog režnja doušne pljuvačne žlezde. Nakon toga se histološkim nalazom utvrđivao tip promene. Nakon sprovođenja hirurške intervencije i potpunog uklanjanja obolelog tkiva uzorak je ispitan za uspostavljanje konačne dijagnoze. Rezultati. Senzitivnost postupka iznosila je 90.9% za doušnu pljuvačnu žlezdu i 74% za podviličnu pljuvačnu žlezdu, specifičnost je bila 95.9% za doušnu pljuvačnu žlezdu i 93% za podviličnu pljuvačnu žlezdu i preciznost je bila 94.7% za doušnu pljuvačnu žlezdu i 87% za podviličnu pljuvačnu žlezdu. Na osnovu histopatološkog nalaza biopsije šupljom iglom bilo je moguće diferencirati maligne od benignih lezija. Zaključak. Sprovedeno istraživanje ukazuje na prednost i efikasnost biopsije šupljom iglom u dijagnozi tumefakata doušne i podvilične pljuvačne žlezde.

Introduction/Aim. The diagnosis of tumors of salivary glands relies heavily on radiological examination and biopsy of pathological tissue. The purpose of the present study is to investigate the sensitivity, specificity and accuracy of core needle biopsy in diagnosis of tumors of parotid and submandibular glands. Methods. This study was designed as a prospective clinical trial preformed between May 3 2008. and Мay 2015. at Department for otorhinolaryngology and maxillofacial surgery, Clinical Center Zemun, Belgrade.Examinations included 200 patients among which 100 were diagnosed with tumors of parotid salivary glands and 100 with tumors of submandibular salivary glands. Core needle biopsy was undertaken in all cases where tumor was smaller than 2 cm, far from blood vessels and far from the deep layer of parotid gland. Histopathological analysis was performed to identify histological type of the lesion. Upon performing the surgical procedure and consequently extirpation biopsies samples were investigated for definitive diagnosis. Results. The sensitivity of the procedure was 90.9% for parotid salivary gland and 74% for submandibular salivary gland, the specificity was 95.9% for parotid salivary gland and 93% for submandibular salivary gland and the accuracy was 94.7% for parotid salivary gland and 87% for submandibular salivary gland. Based on histopathological findings of the salivary gland obtained using core needle biopsy of the tumor tissue, it was possible to differentiate between malign and benign lesions. Conclusion. Current investigation points to the advantages and efficiency of core needle biopsy in diagnosis of tumors of parotid and submandibular salivary glands.