Sputum cytology by the saccomanno method in diagnosing lung malignancy

Abstract

From 1,488 patients, satisfactory sputum was available for cytologic diagnosis. Overall diagnoses were correct in 85.4% of patients, false negative in 193 patients (13.0%), and false positive in 24 patients (1.6%). In patients with a malignant lung process, cytologic diagnoses were correct in 228 patients (54.2%) and false negative in 193 patients (45.8%). In patients with primary lung cancer, the proportion of correct positive diagnoses increased from 0.47 to 0.87 with one to five sputum specimens examined. In patients with metastatic disease, the figures were 0.35 with one specimen examined and 0.38 with two and more sputum specimens. Cytologic typing accuracy was 67% for large-cell carcinomas, 73% for adenocarcinomas, 91% for small-cell lung cancers, and 98% for squamous-cell carcinomas. For the clinically most relevant groups of nonsmall-cell lung cancer and small-cell lung cancer, these figures were 99% and 91%, respectively.

Sequential molecular abnormalities are involved in the multistage development of squamous cell lung carcinoma

“…These ®ndings suggest that dysplasias represent a heterogeneous group of lesions at a molecular level. As only a fraction (10% of moderate dysplasia, 40 ± 80% of severe dysplasias) are believed to progress to cancer (Band et al, 1986;Frost et al, 1986;Risse et al, 1988) molecular studies may aid in the identi®cation of the subgroups of smokers with dysplasia who are at the greatest risk of progression to lung cancer.…”

Epigenetics in lung cancer diagnosis and therapy

“…Cytological typing accuracy among NSCLC was highest for squamous cell carcinoma (98 %) and reduced to 73 and 67 % in adenocarcinoma and large cell carcinoma, respectively. Cytologic typing accuracy was 91 % for SCLC [56]. Analysis of promoter methylation of RASSF1A combined with 3OST2 in sputum specimen demonstrated a sensitivity of 85 % with a specificity of 74 % [57].…”

“…However, unless patients are trained for proper sputum collection, sampling may be inadequate because of overrepresentation of epithelial cells resulting in underestimation of the methylation level in cancer cells. Nevertheless, this method needs at least five sputum specimens to achieve the highest possible proportion of correct positive diagnoses [56]. Sputum cytology is still implemented as standard diagnostic tool for lung cancer diagnosis [64].…”

Diagnosing intra-abdominal malignancy

“…19 22 23 The chance of detecting abnormal cells increased with: (1) centrally located tumours; (2) large and/or high stage tumours; (3) squamous cell carcinomas rather than adenocarcinomas (probably because squamous cell carcinomas are frequently more centrally located); and (4) increasing number of sputum samples. [23][24][25] ''A sputum sample is considered representative if alveolar macrophages or bronchial epithelial cells are present because this shows that the samples originate from deep within the lung'' Sputum cytology plays a limited role in prospective lung cancer screening studies. Malignant cells were present in the sputum of 11 of the 39 lung cancer cases detected (5226 sputum examinations, 11 squamous cell carcinomas and an additional 14 cases with marked atypia).…”