APPLICATION OF THE MILAN SYSTEM IN CYTOLOGICAL DIAGNOSIS AND MALIGNANCY PREDICTION OF PAROTID GLAND TUMORS

Luong Huu Dang1,2,, Tran Vo Quynh Anh2, Nguyen Kieu Diem2
1 Department of Otolaryngology, University Medical Center Ho Chi Minh City, Ho Chi Minh city, Vietnam
2 Department of Otolaryngology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh city, Vietnam

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Tóm tắt

Objectives: In Vietnam, the Milan system for Reporting Salivary Gland Cytopathology has been widely adopted in the cytological diagnosis of parotid gland tumors, contributing to the risk assessment of malignancy and neoplasia in these tumors. This study was conducted to evaluate the utility of the Milan system in fine-needle aspiration cytology (FNAC) by comparing cytological results with histopathological findings of parotid gland tumor cases.


Methods: A cross-sectional descriptive study was performed on patients diagnosed with parotid gland tumors at the Department of Otorhinolaryngology, University Medical Center Ho Chi Minh City.


Results: From January 2021 to May 2024, 157 patients with parotid gland tumors were included in the study. Among them, 151 patients had unilateral parotid gland tumors, while 6 patients had bilateral parotid gland tumors. Regarding the diagnostic value for malignancy risk, the Milan system demonstrated high sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy. Specifically, the specificity, negative predictive value, and accuracy were above 90%. For neoplastic risk assessment, the Milan system showed high sensitivity, specificity, positive predictive value, and accuracy (over 90%); however, the negative predictive value was relatively low at 55.56%.


Conclusion: The Milan system proved highly valuable in distinguishing between benign and malignant lesions and identifying cases requiring classification into uncertain diagnostic categories.

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Tài liệu tham khảo

1. Jennifer R. Wang, D. M. B., Ehab Y. Hanna. Benign Neoplasmas of the Salivary Glands. In Cummings Otolaryngology: Head and Neck Surgery, 7 ed. Philadelphia, PA: Elsevier; 2021: 1171-1188.
2. Hứa Chí Minh, Nguyễn Văn Thành, Hứa Thị Ngọc Hà. Nghiên cứu giá trị chẩn đoán của phương pháp chọc hút bằng kim nhỏ trên bướu tuyến nước bọt. Y học TP Hồ Chí Minh. 2003; 7(4):60-64.
3. Higuchi K., Urano M., Akiba J., Nogami M., Hirata Y., Zukeran Y., et al. A multi-institutional study of salivary gland cytopathology: Application of the Milan System for Reporting Salivary Gland Cytopathology in Japan. Cancer Cytopathol. 2022; 130(1): 30-40.
4. Đăng, P. N. H. Khảo sát giá trị của hệ thống Milan trong báo cáo kết quả tế bào bệnh học tuyến nước bọt. University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 2020.
5. Lee J. J. L., Tan H. M., Chua D. Y. S., Chung J. G. K., Nga M. E. The Milan system for reporting salivary gland cytology: A retrospective analysis of 1384 cases in a tertiary Southeast Asian institution. Cancer Cytopathol. 2020; 128(5): 348-358.
6. Savant D., Jin C., Chau K., Hagan T., Chowdhury M., Koppenhafer J., et al. Risk stratification of salivary gland cytology utilizing the Milan system of classification. Diagn Cytopathol. 2019; 47 (3): 172-180.
7. Viswanathan K., Sung S., Scognamiglio T., Yang G. C. H., Siddiqui M. T., Rao R. A. The role of the Milan System for Reporting Salivary Gland Cytopathology: A 5-year institutional experience. Cancer Cytopathol. 2018; 126(8): 541-551.
8. Tochtermann G., Nowack M., Hagen C., Rupp N. J., Ikenberg K., Broglie M. A., Saro F., Lenggenhager D., Bode P. K. The Milan system for reporting salivary gland cytopathology-A single-center study of 2156 cases. Cancer Med. 2023; 12(11): 12198-12207.