Exfoliative cytology in laryngology: Comparison of cytologic and histologic diagnoses in 350 microlaryngoscopic examinations–A prospective study

Lundgren, Jan; Olofsson, Jan; Hellquist, Henrik; Strandh, J

doi:10.1002/1097-0142(19810315)47:6<1336::aid-cncr2820470617>3.0.co;2-1

Cited by 18 publications

(12 citation statements)

References 23 publications

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“…Laryngeal cytology has been investigated in several studies with variable results, ranging from an extremely high percentage of compatibility with the histopathologic finding to <50% compatibility. [10][11][12][13] Therefore, exfoliative laryngeal cytology is used only sporadically, and the majority of otorhinolaryngology departments still prefer conventional biopsy, which remains the gold standard. 10 Therefore, an objective, noninvasive method is needed for the early detection of laryngeal lesions that may progress to malignancy: a method that will be sensitive and easy to perform in the daily clinical setting.…”

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confidence: 86%

Noninvasive detection of aneuploid cells in laryngeal epithelial precursor lesions

Shani

Primov-Fever

Wolf

et al. 2011

Cancer Cytopathology

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BACKGROUND:Most cases of laryngeal cancer are preceded by precursor lesions which, if left untreated, can progress toward an invasive cancer. The objective of this study was to investigate the presence of chromosomal numerical aberrations in cells that were collected by noninvasive brush sampling from laryngeal lesions.METHODS:Laryngeal brush samples from 52 patients were analyzed simultaneously for morphology and fluorescence in situ hybridization (FISH) using centromeric probes for chromosome 17, chromosome 8, and a locus‐specific instability (LSI) v‐myc avian myelocytomatosis viral oncogene homolog (myc) proto‐oncogene protein (C‐MYC) probe for the MYC gene. The patients were divided according to histopathologic diagnosis. Group 1 included patients with squamous cell carcinoma, carcinoma in situ, and severe dysplasia; Group 2 included patients with moderate dysplasia, mild dysplasia, and hyperplasia; and Group 3 included patients with benign nondysplastic lesions.RESULTS:The proportion of cells with MYC and chromosome 8 gains demonstrated significant trends toward being the highest in Group 1 and the lowest in Group 3 (P = .001 and P = .003, respectively). No significant trend was observed for chromosome 17. Mann‐Whitney Bonferroni‐corrected analyses revealed that the most significant contribution was the difference between Groups 1 and 3 (P = .0195 for MYC gains and P = .036 for chromosome 8 gains). When using a cutoff point of 4% aneuploid cells (ACs), both MYC and chromosome 8 differed significantly between groups (P = .030 and P = .037, respectively).CONCLUSIONS:The current results suggested that FISH analysis of brush samples obtained noninvasively from suspicious laryngeal lesions can augment the clinical examination in predicting the nature of the lesions and can aid clinicians in monitoring and follow‐up of high‐risk patients. Cancer (Cancer Cytopathol) 2011. © 2011 American Cancer Society.

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confidence: 86%

Noninvasive detection of aneuploid cells in laryngeal epithelial precursor lesions

Shani

Primov-Fever

Wolf

et al. 2011

Cancer Cytopathology

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“…In two prospective studies by Lau and coworkers [10] and Lundgren and coworkers [12] the diagnostic sensitivity of cytologic examination in diagnosing histologically malignant tumors was 71% and 83%, respectively. Lau et al used a silk swab stick to diagnose nasopharyngeal carcinomas and Lundgren et al used a wooden pin and a brush to diagnose laryngeal carcinomas.…”

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confidence: 69%

Cytology in Upper Respiratory Tract

Berner

2002

Ultrastructural Pathology

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Respiratory tract cytology is well recognized and widely accepted as the initial step in the diagnosis of respiratory tumors. In particular, bronchial and lung tumors are diagnosed by cytologic examination of either exfoliated cells in sputum or bronchial brush and lavage specimens. Lesions in the upper respiratory tract, including the nasal cavities, mouth, pharynx and larynx, can also be diagnosed using cytology. However, tumors are rare events in the upper airways and relatively few studies have been published [2, 3, 6, 10, 12¡15]. The ¢rst report of cytologic evaluation of exfoliated oral and pharyngeal epithelial cells was published by Beale in 1860. Other authors have since contributed to cytologic examination of the upper respiratory tract. The advantage of cytology is that the collection of cells is simple and usually harmless to the patient and potentially malignant cells, which have lost their cohesiveness to adjacent tissues, are preferentially sampled.Early detection of tumors is crucial for patient survival and false negative results are of particularly great concern. In cervical cytology it is widely acknowledged that up to two thirds of the overall false-negative rates can be attributed to sampling errors. Sampling errors represent a failure to harvest and present diagnostic cells.Nasopharyngeal scrape and brush cytology has been employed to detect both benign and malignant conditions [6,7,10,15].The present article by Merigo and coworkers [7] in this issue of Ultrastructural Pathology presents electron microscopic examination of nasal mucosa from asthmatic children as an ancillary diagnostic method. The specimens were collected by brush cytology and the authors conclude that this minimal invasive test detects mucosal changes that could be related to allergy. Complications related to bronchoscopy were avoided. Granados and coworkers [6] similarly used nasal scrape cytology to diagnose Wegeners granulomatosis, whereas Voss and coworkers [15] identi¢ed precancerous lesions in nasal mucosa of individuals with occupational exposure to nickel and wood. They concluded that brushing and scraping method enables one to collect cells from a larger area than the one sampled by biopsy, thereby yielding more diagnostic material.In two prospective studies by Lau and coworkers [10] and Lundgren and coworkers [12] the diagnostic sensitivity of cytologic examination in diagnosing histologically malignant tumors was 71% and 83%, respectively. Lau et al. used a silk swab stick to diagnose nasopharyngeal carcinomas and Lundgren et al. used a wooden pin and a brush to diagnose laryngeal carcinomas. Adequacy of material, quality of staining and sampling dif¢culties were the major limiting factors, in agreement with Chen and coworkers [2].Fine needle aspiration cytology (FNA) has been shown to be a reliable and safe technique for the diagnosis of malignancy in the head and neck region. The FNA technique is particularly useful in this region because so many disparate entities may be considered in the differential diagnos...

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“…Although the exfoliative cytology is regarded as a revelation in the screening of cervical cancer, its use in the larynx has been underestimated for many years. A number of studies have evaluated the application of exfoliative cytology in comparison with the widely applied histological examination in laryngeal lesions presenting results that vary from extremely high to less than 50% [ 5 , 7 – 13 ].…”

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confidence: 99%

Brush Cytology with Immunocytochemical Evaluation of VEGF Expression versus Biopsy in Clinically Precancerous Laryngeal Lesions: Can We Diagnose Laryngeal Cancer Only with Brush Cytology?

Chatziavramidis

Tsinaslanidou

Valeri³

et al. 2015

Analytical Cellular Pathology

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Introduction. Laryngeal squamous cell carcinoma (LSCC) is the most common SCC of the head and neck. The high incidence of this malignancy and the low survival rate necessitate the development of novel diagnostic approaches. Aim of this study is to compare the diagnostic value of laryngeal brush cytology combined with VEGF immunocytochemistry versus histopathology of clinically precancerous lesions of the larynx. Material and Methods. Thirty patients with precancerous or suspected malignant laryngeal lesions underwent microlaryngoscopy, during which samples were taken for cytological, immunocytochemical, and histological analysis. Cytology and histology results were classified as follows: benign lesions, atypia/moderate dysplasia, and malignancy, whereas the expression of VEGF was evaluated as strong, moderate, weak, and zero expression, based on the percentage of cells stained. Results. The cytology results were in accordance with the histology results in 86.7% of the patients. The exfoliative cytology's sensitivity was estimated at 85% and its specificity at 90%. Its positive prognostic value was 94%, while its negative prognostic value was 75%. The additional immunocytochemical evaluation of VEGF expression increased all the noted parameters. Discussion. Exfoliative cytology of laryngeal lesions is a minimal-invasive, easily applicable procedure during microlaryngoscopy and reliable in terms of diagnostic value. Under certain conditions it could be held also in local anesthesia. Concurrent immunocytochemical analysis of VEGF expression further enhances its diagnostic value.

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Exfoliative cytology in laryngology: Comparison of cytologic and histologic diagnoses in 350 microlaryngoscopic examinations–A prospective study

Cited by 18 publications

References 23 publications

Noninvasive detection of aneuploid cells in laryngeal epithelial precursor lesions

Noninvasive detection of aneuploid cells in laryngeal epithelial precursor lesions

Cytology in Upper Respiratory Tract

Brush Cytology with Immunocytochemical Evaluation of VEGF Expression versus Biopsy in Clinically Precancerous Laryngeal Lesions: Can We Diagnose Laryngeal Cancer Only with Brush Cytology?

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