Implementation of the Milan System for Reporting Salivary Gland Cytology: A Two-Year Outcome Cytopathology Data of a Tertiary Care Center

TL;DR

This study evaluates the effectiveness of the Milan System for classifying salivary gland lesions and its impact on diagnostic accuracy and treatment decisions.

Contribution

The study provides a two-year outcome analysis of the Milan System's implementation in a tertiary care center.

Findings

The FNA cytopathology test showed a sensitivity of 75% and specificity of 93.16%.

The test had an accuracy of 89.66% with a positive predictive value of 72.41%.

The Milan System demonstrated almost universal agreement in classifying salivary gland lesions.

Abstract

Objective: In 2015, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was implemented to eliminate overlapping and disparate morphologies in salivary gland lesions. This approach helps track diagnostic findings, describe the risk of malignancy for each group, and advance therapy based on the results. The research aimed to classify fine-needle aspiration (FNA) smears, analyze malignancy risk, correlate cytology with histological diagnosis, and reduce unnecessary surgeries.

Methodology: We evaluated 217 individuals using FNA, classified their conditions using the Milan System, and followed up on 149 cases through histopathology. Both the risk of malignancy in each cluster and the total risk of malignancy were noted.

Results: The most recent studies, as reported by the MSRSGC, found almost universal agreement about this grouping. The FNA cytopathology test demonstrated a sensitivity of 75% for identifying salivary gland abnormalities and a specificity of 93.16%. The findings indicated that the test had an accuracy of 89.66%, with a positive predictive value of 72.41% and a negative predictive value of 93.97%.

Conclusion: The MSRSGC offers a standardized technique for examining the results and assists the physician in determining the treatment plan that will be most beneficial.