Comparison of the Sensitivity of Sputum and Brush Cytology in the Diagnosis of Lung Carcinomas

Sing, Andreas; Freudenberg, Nikolaus; Kortsik, C.; Wertzel, H; Klosa, Barbara; Hasse, J

doi:10.1159/000332531

Cited by 55 publications

(37 citation statements)

References 38 publications

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“…A point that claims our attention is that most of the studies routinely used fluoroscopy as guidance to increase the sensitivity of bronchoscopy. Few studies were conducted with non-guidance conventional bronchoscopy, and these were conducted for the cases confined to malignancies, those mixed with peripheral lung lesions visible bronchoscopically, and those performed with only brushing or washing 8,[21][22][23][24] . The bronchus sign on CT denotes the presence of a bronchus leading directly to a peripheral lung lesion 18 .…”

Section: Discussionmentioning

confidence: 99%

Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Lee

Kang

Ban

et al. 2016

Chest

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Background:We aimed to analyze the factors predicting the diagnostic performance of flexible bronchoscopy without guidance in peripheral lung lesions that are endoscopically invisible. Methods: This was a retrospective study conducted in St. Paul's Hospital, The Catholic University of Korea, between January 2007 and March 2013. We included all patients who received bronchoscopy during this period. The analyzed variables were age, sex, the etiology of the lesion, lesion size, distance from the pleura, and presence of the bronchus sign. We used multiple logistic regression analysis to identify the significant independent factors associated with diagnostic yield. Results: We included 151 patients in this study. The overall diagnostic yield was 58.3%. The sensitivity was 43.2% for malignant disease and 78.1% for benign disease. The benign lung lesions (p<0.001), lesion size (p=0.015), presence of the exposed type of bronchus sign (p<0.001), and presence of cavitary lung lesions (p=0.005) were factors influencing the yield of flexible bronchoscopy by univariate analysis. In a multivariate logistic regression analysis, the exposed type of bronchus sign and benign lung lesions were independent predicting factors (odds ratio [OR]: 27.95; 95% confidence interval [CI], p<0.001 and OR, 4.91; 95% CI, p=0.002). Conclusion:The presence of the exposed type of bronchus sign and benign lung lesions are determining factors of the diagnostic yield in flexible bronchoscopy in evaluating peripheral lesions that are not endoscopically visible.

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Section: Discussionmentioning

confidence: 99%

Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Lee

Kang

Ban

et al. 2016

Chest

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“…In a study revisiting 60 representative studies to assess the sensitivity of sputum cytology [27], an average sensitivity of 64.5% with a range of 22.0-98.1% was calculated. The reviewers9 own results showed a sensitivity of 40.3% for sputum cytology [27], which was comparable to earlier reports in the literature [5], but not as exceptionally high as the sensitivity of sputum cytology reported by BÖ CKING et al [28], who used a combination of cytology on three separate samples, quantitative cytometry and immunohistochemistry (paraffin-embedded sputum).…”

Section: Discussionmentioning

confidence: 99%

“…PIROZYNSKI [30] reported a sensitivity of 64% in a comparable study. Several authors describe the dependence of the sensitivity of cytologically investigated sputa and bronchial washings on tumour location and size [27,30]. A parallel investigation of endoscopic findings in 142 patients with suspected bronchopulmonary tumours showed the following growth patterns: 22% mainly submucosal tumour growth, 44% exophytic tumours localized in the visual range, 11% peripheral lesions not visible with bronchoscopy [1].…”

Section: Discussionmentioning

confidence: 99%

Can semi-automated image cytometry on induced sputum become a screening tool for lung cancer?: Evaluation of quantitative semi-automated sputum cytometry on radon- and uranium-exposed workers

Marek¹,

Kotschy-Lang²,

Muti³

et al. 2001

European Respiratory Journal

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The correlations between semi-automated sputum cytometry (ASC), conventional cytology and the final diagnosis was investigated in industrially-exposed workers. Slides of sputum samples from 201 former uranium miners with silicosis, 100 patients with asbestosis, 103 workers resected for lung cancer, and 200 controls (50% smokers), were stained using the Papanicolaou (Pap) method and the Feulgen reaction with thionin. Cytometry was performed using the Cyto-Savant automated system. Atypical nuclei were found in 72 of 404 patient samples, 327 samples were normal and five were inadequate for ASC analysis. Thirteen tumours (Pap IV, Pap V) and 11 cases of severe dysplasia were identified by cytology. Lung cancer was confirmed in 20 patients. Compared to the final diagnosis of lung cancer, the sensitivity of ASC was 75% (15 out of 20) and specificity 89.8% (520 out of 579). The results represent a diagnostic efficiency of 89.3%. The combination of ASC with cytology increased sensitivity to 80% (16 out of 20) without significant loss of specificity (89.7% or 523 out of 581).In this investigation of a limited number of patients with occupational radon or asbestos exposure, semi-automated sputum cytometry appears to be sensitive and reliable for the detection of malignant changes in the tracheobronchial mucosa. Together with conventional cytology, it would be reasonable to test the validity of the combined methods in a large-scale feasibility study of early lung cancer detection. Eur Respir J 2001; 18: 942-950.

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“…When permitted by material adequacy, a panel of commercially available antibodies against keratins (AE1/3) (dilution 1:100), calretinin (1:100) and epithelial membrane antigen (EMA) (1:100) was applied on archival Papanicolaou-stained smears following the directions published elsewhere. 5,6 Paraffin sections from biopsy specimens were also stained for the same antigens; in addition, testing for keratin 5/6 (1:200), vimentin (1:100) and carcinoembryonic antigen (CEA) (1:50) was carried out. Antibody against AE1/3 was purchased from Dako (Santa Barbara, California, U.S.A.), calretinin from Zymed (South San Francisco, California, U.S.A.) and the remainder from BioGenex (San Ramon, California, U.S.A.).…”

Section: Methodsmentioning

confidence: 99%

Bronchial Cytology in Pleural Mesothelioma

DellaGiustina¹,

Falconieri²,

Gori³

et al. 2003

Acta Cytologica

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Comparison of the Sensitivity of Sputum and Brush Cytology in the Diagnosis of Lung Carcinomas

Cited by 55 publications

References 38 publications

Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Can semi-automated image cytometry on induced sputum become a screening tool for lung cancer?: Evaluation of quantitative semi-automated sputum cytometry on radon- and uranium-exposed workers

Bronchial Cytology in Pleural Mesothelioma

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