Diagnostic accuracy of fine-needle aspiration cytology in salivary gland neoplasms: a systematic review and meta-analysis.

INTRODUCTION

Fine-needle aspiration cytology is a widely used minimally invasive tool for salivary gland lesions, though diagnostic challenges arise due to overlapping features between benign and malignant tumors. This systematic review and meta-analysis evaluate its diagnostic performance in salivary gland neoplasms.

METHODS

A comprehensive literature search was conducted in PubMed/MEDLINE, Embase, Scopus, and Web of Science. Studies reporting sensitivity, specificity, or sufficient data to construct 2 × 2 tables were included. Data extraction was performed independently by two reviewers, and study quality was assessed using the QUADAS-2 tool. Diagnostic accuracy was pooled using a bivariate random-effects model, and summary receiver operating characteristic curves were generated. Publication bias was evaluated using Deeks' funnel plot.

RESULTS

A total of 56 studies were included, of which 32 were eligible for meta-analysis. The pooled sensitivity of FNAC was 0.79 (95% CI: 0.75-0.83), and specificity was 0.94 (95% CI: 0.93-0.96). The summary analysis demonstrated good discriminative ability with an area under the curve of 0.89. No significant publication bias was detected.

CONCLUSIONS

FNAC demonstrates high diagnostic accuracy, with high specificity and moderate sensitivity, supporting its role as a reliable first-line diagnostic tool in salivary gland neoplasms.