Evidence map›Paper›PMID 34478237›Full record

ArticleCancer cytopathology2022

A multi-institutional study of salivary gland cytopathology: Application of the Milan System for Reporting Salivary Gland Cytopathology in Japan.

Kayoko Higuchi, Makoto Urano, Jun Akiba, Miwako Nogami, Yukiya Hirata, Yoko Zukeran, Koki Moriyoshi, Yuichiro Tada, Mana Fukushima, Mariko Obayashi and 9 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer cytopathology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Limitations of FNAC in detecting parotid malignancies: insights from a surgical cohort using the updated Milan System.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Kayoko HiguchiDepartment of Surgical Pathology, Okinawa Kyodo Hospital, Naha, Japan.ORCID 0000-0001-5610-9513
Makoto UranoDepartment of Diagnostic Pathology, Bantane Hospital, Fujita Health University, Nagoya, Japan.
Jun AkibaDepartment of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.ORCID 0000-0003-2657-8604
Miwako NogamiDivision of Diagnostic Pathology, Kyushu University Hospital, Fukuoka, Japan.
Yukiya HirataDepartment of Pathology, University of the Ryukyus Hospital, Nishihara, Japan.
Yoko ZukeranDepartment of Pathology, University of the Ryukyus Hospital, Nishihara, Japan.
Koki MoriyoshiDepartment of Diagnostic Pathology, Kyoto Medical Center, Kyoto, Japan.
Yuichiro TadaDepartment of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.ORCID 0000-0002-0159-8660
Mana FukushimaDepartment of Surgical Pathology, Ehime University Hospital, Toon, Japan.
Mariko ObayashiDepartment of Diagnostic Pathology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan.
Shinnichi SakamotoDepartment of Diagnostic Pathology, Kure Medical Center and Chugoku Cancer Center, Kure, Japan.
Kazuya KuraokaDepartment of Diagnostic Pathology, Kure Medical Center and Chugoku Cancer Center, Kure, Japan.
Kana KiraDepartment of Diagnostic Pathology, Kochi University Hospital, Nangoku, Japan.
Akihiko KawaharaDepartment of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.ORCID 0000-0002-4081-2519
Taku KatoDepartment of Pathology, Naritatomisato Tokushukai Hospital, Tomisato, Japan.
Maki TanigawaDepartment of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
Masato NakaguroDepartment of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.ORCID 0000-0001-6987-3043
Hidetaka YamamotoDivision of Diagnostic Pathology, Kyushu University Hospital, Fukuoka, Japan.
Toshitaka NagaoDepartment of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.ORCID 0000-0003-2075-9738

Funding

The Japanese Society of Clinical Cytology
6 · The paper itself

Abstract

backgroundThe Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a risk-stratification reporting system that was introduced in 2018. The objective of this multi-institutional study was to evaluate the utility of the MSRSGC in Japan.

methodsIn total, 1608 fine-needle aspiration samples with matching histologic diagnoses were retrieved from 12 large institutions in Japan. The diagnostic categories of the MSRSGC were assigned prospectively or retrospectively, and the results were compared with the histologic diagnoses.

resultsThe cases were classified as follows: nondiagnostic, 18.1%; non-neoplastic, 4.1%; atypia of undetermined significance, 11.5%; neoplasm-benign, 43.7%; salivary gland neoplasm of uncertain malignant potential, 9.6%; suspicious for malignancy, 3.6%; and malignant, 9.4%. The risk of neoplasm and the risk of malignancy in each MSRSGC category were as follows: nondiagnostic, 72.9% and 13.4%, respectively; non-neoplastic, 15.2% and 9.1%, respectively; atypia of undetermined significance, 77.9% and 24.9%, respectively; neoplasm-benign, 99% and 1.8%, respectively; salivary gland neoplasm of uncertain malignant potential, 94.8% and 37%, respectively; suspicious for malignancy, 100% and 89.7%, respectively; and malignant, 100% and 99.3%, respectively. The accuracy of the MSRSGC for diagnosing neoplasms was 97.8%, and its accuracy for diagnosing malignancy was 97.3%. Institutions that used Romanowsky-stained preparations had lower nondiagnostic rates and lower risks of neoplasm and malignancy in the non-neoplastic category.

conclusionsThe MSRSGC is useful for risk stratification and quality control. Widespread use of the MSRSGC would improve the accuracy of salivary gland cytology and lead to better patient care in Japan.

Indexed as

Salivary Gland NeoplasmsSalivary GlandsBiopsy, Fine-NeedleHumansJapanRetrospective Studiesfine-needle aspirationJapanmulti-institutional studysalivary gland cytopathologythe Milan system

Identifiers

PMID34478237
PMCPMC9290724

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.