Diagnostic performance of fine-needle aspiration in salivary gland tumours.

INTRODUCTION

The aim of this study was to evaluate the diagnostic performance of fine-needle aspiration (FNA) cytology and further evaluate the risk of malignancy (ROM) in patients with salivary gland neoplasms in a five-year period in Region Zealand, Denmark.

METHODS

Retrospectively, we identified all patients with an FNA from a salivary gland neoplasm who underwent surgery from 1 January 2020 through 31 December 2024. Descriptive statistics were performed, and sensitivity, specificity, positive and negative predictive values and ROM were estimated.

RESULTS

We identified 435 patients who had a preoperative FNA and underwent surgical excision within the study period. The cohort had a small female preponderance, a mean age of 59.2 years and involvement of the parotid gland in 84.6% of cases. An assessment of the diagnostic efficacy of the FNA between benign and malignant cases reported a sensitivity of 50.0%, a specificity of 97.9%, a positive predictive value of 78.4%, a negative predictive value of 92.7% and an accuracy of 92.0%. The risk of malignancy was low in benign FNAs (0-0.6%) and high in FNAs with malignancy or suspicion hereof (75.0-100%).

CONCLUSIONS

With an accuracy of 91.5% in distinguishing benign from malignant neoplasms, FNA plays a crucial role in both diagnosis and patient counselling. The inherent uncertainty must be considered when recommending and planning surgical interventions or follow-up, especially in unresolved cases.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.