Mulder, S.J. (2017) The difference in diagnostic accuracy of the cytological diagnosis of parotid gland tumors between pathology laboratories affiliated with a head-neck oncology center and pathology laboratories not affiliated with a head-neck oncology center. thesis, Dentistry.
Full text available on request.Abstract
Salivary gland cancer can be diagnosed using fine needle aspiration cytology (FNAC) which can make the distinctiction between malignant and benign neoplasms. This distinction is important because malignant neoplasms require an early and more radical surgery. Furthermore, a reoperation is undesirable because of the higher chance of damage to the facial nerve. In the Netherlands, patients with malignant neoplastic lesions are referred to a head-neck oncology center, according to the national agreement. The pathology laboratories of these head-neck oncology are required to harbour a pathologist dedicated to head and neck tumors with expertise and see more malignant parotid gland tumors. It is unknown whether there is a difference in diagnostic accuracy of classifying FNAC in benign and malignant lesions between laboratories related to a head-neck oncology center and laboratories that are not related to a head-neck oncology center. In this study data from the nationwide network and registry of histo- and cytopathology in the Netherlands (PALGA) was used. In the data inquiry, a selection was made of patients 18 years and older with a benign or malignant parotid gland tumor, with cytological and histological pathology reports available (N=1597). Patients were categorized according to where the first cytological analysis was done, a Pathology laboratory linked to a Head-Neck center (PHN+) or a Pathology laboratory that was not linked to a Head-Neck center (PHN-). The overall sensitivity and specificity in scenario 1, in which only aspirations classified as benign or malignant were included, were 78.6 and 98.7, respectively. For PHN+ and PHN- the sensitivity and specificity equaled 82.6 and 98.4, 72.2 and 98.9, correspondingly. In scenario 2, in which also cytological aspirations classified as non-neoplastic or atypical lesions were included, the sensitivity and specificity were 75.2 and 98.2, overall. In PHN+ and PHN- this equaled 80.0 and 97.6, 68.2 and 98.6, respectively. There were no statistically significant differences in sensitivity and specificity in scenario 1 and 2 between the groups. Concluding, these findings show that laboratories associated with a head-neck oncology center have a statistically insignificant but clinically relevant higher sensitivity and about equal specificity in differentiating benign and malignant parotid gland neoplasms using FNAC compared to laboratories not associated with a head-neck oncology center.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Roodenburg, dr. J.L.N. and Dijk, dr. B.A.C. van and Hemel, drs. van |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 Nov 2021 15:25 |
| Last Modified: | 19 Nov 2021 15:25 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2816 |
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