Fine Needle Puncture Aspiration in Salivary Gland Tumor Evaluation

Study Notes

A puncture aspiration with a fine needle is valuable in pre-operative evaluation of head and neck tumors. However, its precision in treating salivary gland tumors is questionable.
Our objective was to investigate the effectiveness and precision of puncture aspiration with a fine needle in treating salivary gland tumors.
Patients who underwent parotidectomy between January 2008 and June 2017 for salivary gland tumor were retrospectively evaluated.
Patients were included who had pre-operative puncture aspiration with a fine needle and histopathology post-operatively.
The pre-operative puncture aspiration with a fine needle was categorized as benign, malignant or with suspicion of malignity.
The histopathological classification was grouped as benign or malignant.
The histopathological examinations were compared with puncture aspiration with a fine needle and sensitivity, specificity, accuracy and agreement between the two tests were investigated.
217 patients were evaluated and 23 were excluded because the pre-operative diagnosis of puncture aspiration with a fine needle was not conclusive or unavailable. 194 patients were included. The median age of the patients was 47.5 ± 15.88 (7-82). 157 patients were benign, 37 were malignant in puncture aspiration with a fine needle and 165 were benign and 29 were malignant in histopathology. The accuracy of pre-operative diagnosis of malignity was 86.52%.
Sensitivity and specificity were 68.96% and 89.63%, respectively. The positive predictive value was 54.05% and the negative predictive value was 94.23%. There was moderate agreement between puncture aspiration with a fine needle and histopathology (κ = 0.52).
Sensitivity was 54.54% for tumors smaller than 2 cm and 77.77% for tumors larger than 2 cm. Sensitivity was 80% for tumors that extended beyond the midline.
The use of puncture aspiration with a fine needle in combination with clinical and radiological evaluation may help reduce the number of false-positive and false-negative results.