Efficacy of Fine Needle Aspiration Biopsy and Frozen Section Biopsy in Salivary Gland Malignancies

Kwon, Seong Keun; Ahn, Young Jin; Suh, Myung Whan; Chung, Young Ho; Hah, Jeong Hun; Sung, Myung Whun; Kim, Kwang Hyun

Abstract

BACKGROUND AND OBJECTIVES
The aim of this study was to investigate the efficacy of fine needle aspiration biopsy (FNAB) and frozen section biopsy in salivary gland malignancies.
SUBJECTS AND METHOD
From January 1995 through December 2004, 462 patients underwent operation for salivary gland mass. Of these patients, FNABs and frozen section biopsies were performed in 262 and 241 patients, respectively. The medical and pathologic reports were reviewed retrospectively. Malignancies were found in 57 patients.
RESULTS
The sensitivity and the specificity of FNAB to detect salivary gland malignancies were 50.9% and 94.1%, respectively. For the frozen section biopsy, the sensitivity and specificity rose to 90.7% and 99.0%, respectively. When the examination period was divided into period 1 (Jan, 1995-Dec, 1999) and period 2 (Jan, 2000-Dec, 2004), sensitivity showed a significant increase from 33.3% to 57.1%. With respect to pathologic types of the tumors, the sensitivity of FNAB was high in adenocarcinoma (88.9%, 8/9) but low in mucoepidermoid carcinoma (30%, 3/10) and carcinoma ex pleomorphic adenoma (33.3%, 3/9).
CONCLUSION
FNAB alone cannot guarantee accurate diagnosis of salivary gland malignancies. Therefore, intraoperative frozen section biopsy is recommended to make an adequate decision for surgical extent. The clinical experience of pathologists is also an important factor in improving the accuracy of fine needle aspiration biopsy.