The Diagnostic Value Of Fine Needle Aspiration Cytology In Parotid Gland Masses Evaluated By ROC Curve

Objective:The receiver operator characteristic curve(ROC)was used to evaluate the clinical value of fine needle aspiration cytology(FNAC)in the preoperative diagnosis of parotid gland masses.Methods:1.Retrospective analysis was conducted on 148 cases of parotid gland masses examined by FNAC in the department of stomatology of our hospital from 2016 to2018.2.The histopathological diagnosis was used as the gold standard to make statistics on the incidence of parotid gland masses,the disease constitution and the benign and malignant ratio.FNAC diagnostic compliance rate,specificity,sensitivity,positive predictive value(PPV),negative predictive value(NPV),and Youden index(YI)of malignant tumors were calculated.3.ROC Curve of the accuracy rate of FNAC in diagnosing benign and malignant parotid gland tumors was plotted by SPSS 24.0 software,and the Area under the Curve of ROC(AUC)was calculated.4.Combined with PubMed database,we analyzed the safety performance of needle core biopsy(CNB)and its diagnostic tumor classification.By establishing the diagnosis model via ROC curve,we calculated the AUC value,and then compared the diagnostic value of FNAC and CNB.5.By exploring the new direction of FNAC,we analyzed its advantages and disadvantages,and established a stepped-program diagnostic model for parotid gland masses.Results:1.Among 148 cases of parotid gland tumors,the number of male and female cases was 81,67,the ratio was 1.21,and the age ranged from 12 to 87 years old.Except for Warthin tumor,the ratio of male to female was 9:1(27/3),and that of other tumors was 0.84:1(54/64),showing a significant difference(?~2=18.892,P<0.001).2.Among the 148 cases of parotid gland tumors assessed,88(59.5%)were benign tumors,and 23(15.5%)were non-neoplastic lesions.In total,111(75.0%)were benign lesions and 37(25.0%)were malignant tumors.3.The accuracy of FNAC in the diagnosis of parotid gland malignant,benign and non-neoplastic lesions was 64.9%,78.4%and 73.9%,respectively.The coincidence rate of diagnosis of benign and malignant masses was 98.9%,70.3%and 67.6%respectively.The sensitivity of FNAC in the diagnosis of parotid gland malignancy was 70.3%,the specificity was 97.3%,the PPV was 89.7%,and the NPV was 90.8%.4.We plotted the ROC curve diagnostic model of FNAC for parotid gland masses,and obtained the AUC value of 0.751(95%CI:0.559~0.944),indicating that FNAC has certain diagnostic value in the diagnosis of parotid gland masses.5.By plotting the ROC curve of FNAC for the diagnosis accuracy of benign and malignant parotid tumors,the AUC values of the benign and malignant tumors were calculated as 0.833(95%CI:0.598~1.000)and 0.681(95%CI:0.369~0.992),respectively.This suggests that FNAC has a certain diagnostic value in the diagnosis of parotid benign tumors,while it has a lower value in the diagnosis of parotid malignant tumors than benign tumors.6.The diagnostic differences between CNB and FNAC were compared by searching the CNB-related literature in PubMed database,and the chi-square test was used.The results showed that the differences were statistically significant in the diagnosis of benign tumor typing(?~2=10.576,P<0.05).There was a significant difference between the two types in the diagnosis of malignant tumor(?~2=36.169,P<0.01).7.By making a ROC diagnostic model for the diagnosis of salivary gland tumor classification with CNB and FNAC,the AUC values of CNB and FNAC were calculated to be 0.837(95%CI:0.688~0.985,P<0.01)and 0.687(95%CI:0.492~0.822,P=0.064,P>0.05),indicating that FNAC has low diagnostic significance for tumor classification,while CNB has high clinical diagnostic value for tumor classification.8.According to the statistics of published literature,the complications caused by CNB are rare and mild,which is similar to the safety of FNAC.Conclusion:Combined with the ROC curve diagnosis model,it was found that FNAC could be used to preliminarily identify benign and malignant parotid tumors.The value of diagnosis of benign parotid tumors was high,but the value of diagnosis of malignant parotid tumors was low,and it was not suitable for preoperative classification of tumors.However,the AUC value was as high as 0.837 when the ROC model was established for the diagnosis of salivary gland tumor typing by core needle biopsy,suggesting that CNB could improve the limitation of FNAC,as well as more accurately characterize the tumor and its tumor typing.Each puncture technique has its own advantages.Traditional FNAC cannot be abandoned,and new techniques should be adopted to make up for its shortcomings.Meanwhile,the stepwise diagnosis was established and the appropriate diagnosis method was selected to improve the diagnostic value of FNAC in parotid gland tumors.