Accuracy of Fine Needle Aspiration Cytology in the Pathological Typing of Non-small Cell Lung Cancer

Nizzoli, Rita; Tiseo, Marcello; Bartolotti, Marco; Majori, Maria; Ferrari, Lilia; Filippo, Massimo De; Rindi, Guido; Silini, Enrico Maria; Guazzi, Annamaria; Ardizzoni, Andrea

doi:10.1097/jto.0b013e31820b86cb

Cited by 93 publications

(93 citation statements)

References 27 publications

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“…A more recent study examined the accuracy of fine-needle aspirate cytology (FNAC) specimens in differentiating squamous from non-squamous NSCLC [33]. The authors retrospectively reviewed 474 patients who had NSCLC diagnosed by FNAC and identified 186 who had tissue retrieved by other means and noted good agreement between cytological and histological diagnoses (k50.755).…”

Section: Lung Cancer Dp Steinfort Et Almentioning

confidence: 99%

Interobserver agreement in determining non-small cell lung cancer subtype in specimens acquired by EBUS-TBNA

et al. 2012

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Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) may diagnose suspected lung cancer. Determination of non-small cell lung cancer (NSCLC) subtype may guide therapy in select patients. Small-volume biopsies may be subject to significant interobserver variability in subtype determination.Three pathologists independently reviewed specimens from 60 patients who underwent EBUS-TBNA for diagnosis/staging of suspected/known NSCLC. Smear, haematoxylin and eosin (H&E) and immunohistochemistry (IHC) specimens were reviewed without reference to other specimen types obtained from the same patient. Final diagnoses, and degree of confidence in the diagnosis, were recorded for each specimen.Almost perfect agreement was seen for distinguishing between small cell lung cancer and NSCLC for all specimen types. Agreement in determination of NSCLC subtype for smear, H&E and IHC specimens was slight (k50.095, 95% CI -0.164-0.355), fair (k50.278, 95% CI 0.075-0.481) and moderate (k50.564, 95% CI 0.338-0.740), respectively. Perfect agreement was seen when all three observers were confident of diagnoses made on IHC specimens.Interobserver agreement in interpretation of EBUS-TBNA specimens is moderate for determination of NSCLC subtype. Agreement is highest following examination of IHC specimens. Clinicians should be aware of the degree of pathologist confidence in the tissue diagnosis prior to commencement of subtype-specific therapy for NSCLC.

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Section: Lung Cancer Dp Steinfort Et Almentioning

confidence: 99%

Interobserver agreement in determining non-small cell lung cancer subtype in specimens acquired by EBUS-TBNA

et al. 2012

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“…However the quantities of pathological materials obtained by biopsy are not always sufficient for subtyping or genotyping; thus in addition to histological specimens, cytological specimens should be used for subtyping, as this might expand treatment choices [14,15]. Nizzoli et al [16] investigated the accuracy of fine needle aspiration cytology (FNAC) in NSCLC typing in comparison to histology. In their study, the cytological and histological typing was concordant in 137 of 156 (88%) cases (K=0.755; p<0.001), and the positive predictive value of FNAC in predicting the type of NSCLC was 92% for adenocarcinoma and 82% for squamous cell carcinoma.…”

Section: Discussionmentioning

confidence: 99%

The Cytomorphological Characteristics of Non-small Cell Lung Cancer are Associated with Its Radiological Features

Tanaka¹,

Sakamoto²,

Suzuki³

et al. 2017

J Cytol Histol

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Background: Distinguishing the histological subtype of lung cancer is extremely important because chemotherapy agents may have different chemotherapeutic effects in different histological subtypes. This study retrospectively evaluated the characteristic differences in the cytomorphological and radiological features of nonsmall cell lung cancer.Methods: This study population included 50 lung cancer patients who were diagnosed based on bronchoscopic biopsy findings and underwent surgery from April 2011 to May 2016. Cyotological specimens (Papanicolaou's staining) were separately analyzed by two experienced cytotechnicians. The associations between the clinicopathological data, as well as the preoperative radiological features on computed tomography (CT) and positron emission tomography (PET) and cytomorphological analyses were analyzed.Results: Forty-five specimens were analyzed (adenocarcinoma [ADC] [n=38], squamous cell carcinomas [SQCC] [n=7]). The ADCs were cytomorphologically sub-classified as follows: acinar (n=25), solid (n=10), lepidic (n=2) and papillary (n=1). Among specimens with a solid pattern of ADC, there was a significantly greater percentage of samples with a necrotic background (50%), predominant 3D clusters (100%) and conspicuous nucleoli (80%) compared to specimens with a nonsolid pattern of ADC. The CT images of patients with solid ADC (90%) and SQCC (100%) tended to show solid nodules on CT. On PET, the maximum standardized uptake values at 120 minutes in solid ADC and SQCC were significantly higher in comparison to nonsolid ADC (12.8 ± 6.1 and 17.2 ± 7.3 versus 8.9 ± 4.4, respectively). Conclusions:The differentiation of the cytomorphological characteristics might predict the values of radiological features, and thereby provide information that can be used when determining the treatment strategies.

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“…Nizzoli R et al [11] analyzed 474 primary NSCLCs cytologically with comparison of 186 cases with parallel endoscopic biopsies or surgical material and concluded that FNAC is fairly accurate for subtyping of NSCLC and in doubtful cases , immunohistochemistry can be added to improve diagnostic yield. In this study, the authors analyzed adenocarcinoma and squamous cell carcinoma based on background, architecture and cytoplasmic and nuclear characteristics as in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…(refer tables 1&2) Non small cell carcinomas were further subtyped into adenocarcinoma(ADC) and squamous cell carcinoma(SCC) based on following features: background, architecture, cytoplasmic and nuclear details and presence of nucleoli. [11,12] (Table 3). Based on these features, 12 and 5 cases were subtyped into adenocarcinoma(figure5a,b,c) and squamous cell carcinoma(figure 6)respectively.…”

Section: Introductionmentioning

confidence: 99%

Cytology of Lung Carcinomas with Subtyping of Non-small Cell lung Carcinoma (NSCLC)

2016

IJSR

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The most common lung tumor was Adenocarcinoma followed by small cell carcinoma. Conclusion: As the treatment modalities are different for both of the tumors accurate subtyping of NSCLC into Adenocarcinoma and Squamous cell carcinoma is very essential so that patients get benefit of specific targeted therapy and appropriate molecular testing can be done. FNAC is a very useful and rapid technique for the diagnosis of lung tumor and can be combined with cytochemical and immunohistochemical stains for exact categorization. So that patient can be managed properly and simultaneously tissue can be preserved for molecular studies.

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Accuracy of Fine Needle Aspiration Cytology in the Pathological Typing of Non-small Cell Lung Cancer

Cited by 93 publications

References 27 publications

Interobserver agreement in determining non-small cell lung cancer subtype in specimens acquired by EBUS-TBNA

Interobserver agreement in determining non-small cell lung cancer subtype in specimens acquired by EBUS-TBNA

The Cytomorphological Characteristics of Non-small Cell Lung Cancer are Associated with Its Radiological Features

Cytology of Lung Carcinomas with Subtyping of Non-small Cell lung Carcinoma (NSCLC)

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