Introduction: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was proposed by the American Society of Cytopathology and the International Academy of Cytology to bring uniformity in the reporting system and the treatment protocol. A wide range of risk of malignancy for each category has been reported by various authors by applying the system. Aim: We intend to study the cytohistological concordance and the ROM for each of the diagnostic categories of the Milan system. Materials and Methods: The study included 292 cases of fine-needle aspiration cytology (FNAC) of salivary gland lesions over a period of 3 years. The diagnosis of these cases was reclassified into the 6 categories of the Milan system. The cytohistological concordance and ROM for each category of the Milan system were calculated based on the clinical and histopathological follow-up. Results: The patients’ age ranged from 3 to 81 years with the mean of 42.65 ± 16.3 years. The cases included 189 (64.7%) parotid, 82 (28.1%) submandibular, and 21 (7.2%) cases of minor salivary gland swellings. Follow-up histopathological diagnosis for 102 cases was available. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated to be 64.28, 97.01, 90, 86.67, and 87.37%, respectively. After reclassification, the number of cases in each category was as follows: category I: 31 (10.62%), category II: 80 (27.4%), category III: 2 (0.68%), category IVA: 143 (48.97%), category IVB: 1 (0.34%), category V: 13 (4.45%), and category VI: 22 (7.53%). The calculated ROM was as follows: category I: 42.86%, category II: 26.67%, category III: 100% category IVA: 10.17%, category IVB: 0%, category V: 71.42%, category VI: 100%. Conclusion: FNAC is an excellent procedure to differentiate benign from malignant tumors, and MSRSGC is a useful system for risk assessment and deciding the further treatment protocol. Our findings also suggest that in addition to the surgical follow-up, inclusion of the clinical and radiological follow-up may be a better strategy for calculation of ROM, especially for categories I and II.
Acta Cytologica

中文翻译：

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米兰报告唾液腺细胞病理学的系统：细胞组织学一致性和恶性肿瘤风险的评估

简介：米兰唾液腺细胞病理学报告系统（MSRSGC）是由美国细胞病理学学会和国际细胞学学会提议的，目的是使报告系统和治疗方案统一。通过使用该系统，各个作者已经报告了每种类别的各种恶性风险。目的：我们打算研究米兰系统每个诊断类别的细胞组织学一致性和ROM。材料和方法：这项研究包括292例唾液腺病变的细针穿刺细胞学检查（FNAC），历时3年。这些病例的诊断被重新分类为米兰体系的6类。基于临床和组织病理学随访，计算了米兰系统各类别的细胞组织学一致性和ROM。结果：患者年龄为3至81岁，平均42.65±16.3岁。病例包括189例（64.7％）腮腺，82例（28.1％）下颌下腺和21例（7.2％）小涎腺肿胀。可以对102例患者进行随访的组织病理学诊断。敏感性，特异性，阳性预测值，阴性预测值和准确性分别计算为64.28、97.01、90、86.67和87.37％。重新分类后，每个类别的病例数如下：第一类：31（10.62％），第二类：80（27.4％），第三类：2（0.68％），IVA类别：143（48.97％）， IVB类：1（0.34％），V类：13（4.45％），VI类：22（7.53％）。计算出的ROM如下：I类：42.86％，II类：26.67％，III类：100％IVA类：10.17％，IVB类：0％，V类：71.42％，结论： FNAC是区分良性肿瘤与恶性肿瘤的绝佳方法，而MSRSGC是用于评估风险和确定进一步治疗方案的有用系统。我们的发现还表明，除了外科手术随访外，包括临床和放射学随访可能是计算ROM的更好策略，尤其是对于I和II类。
细胞学学报