Pouzdanost aspiracije tankom iglom i biopsije ex tempore u dijagnostici lezija pljuvačnih žlijezda
Sažetak
Uvod/Cilj. Citološka interpretacija materijala dobijenih aspiracijom tankom iglom (fine-needle aspiration – FNA) pljuvačnih žlijezda predstavlja jedno od najzahtjevnijih područja u citopatologiji. FNA se izvodi lako, brzo, pouzdano, minimalno invazivno, jeftino, pružajući značajne informacije kliničarima o prirodi lezije i terapijskim modalitetima. Ex tempore dijagnostika (frozen section – FS) je dijagnostička metoda koja je bitna pri određivanju modaliteta hirurškog liječenja lezija u pljuvačnim žlijezdama. Danas se ova metoda koristi za određivanje statusa resekcionih rubova i infiltracije susjednih anatomskih struktura. Cilj istraživanja bio je da se prikažu sopstvena iskustva u primjeni FNA i FS u dijagnostici lezija pljuvačnih žlijezda, te da se utvrdi osetljivost, specifičnost, vrijednost predviđanja i dijagnostička pouzdanost ovih metoda. Metode. Ispitivanjem je obuhvaćeno 36 bolesnika. Kod svih je urađena citološka analiza prije operativnog zahvata i histološka analiza operativnog materijala. Kod 23 bolesnika urađena je dijagnostika FS. Izvršeno je poređenje FNA i FS nalaza sa patohistološkim nalazima. Rezultati. Korelacijom citoloških i patohistoloških dijagnoza osetljivost je iznosila 83,3%, specifičnost 96,67%, pozitivna vrijednost predviđanja 83,3%, negativna vrijednost predviđanja 96,77% i dijagnostička pouzdanost 97,2%. Na osnovu odnosa FS dijagnoza i patohistoloških dijagnoza osjetljivosti je iznosila 100%, specifičnost 96,67%, a pozitivna vrijednost predviđanja i dijagnostička pouzdanost iznosili su 100%. Zaključak. Istraživanje je potvrdilo da je FNA osjetljiva i dijagnostički pouzdana metoda za diferencijaciju lezija u pljuvačnim žlijezdama. U slučaju nemogućnosti definitivne diferencijacije u FNA uzorcima, te potrebe da se izvrši procjena resekcionih rubova i invazija anatomskih struktura, preporučuje se FS dijagnostika.
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