Abstract
The majority of lung cancer patients are diagnosed at advanced stages of disease. This study evaluated the diagnostic value of ThinPrep (TP) bronchial brushing cytology in lung cancer. A total of 595 patients with suspicious lung cancer were enrolled in this study. The bronchial brushing samples were prepared by TP. The data were then compared to histology of lung tissue samples. Histologically, 479 of these 595 patients were diagnosed with lung cancer, including 223 cases of lung squamous cell carcinoma (SCC), 77 cases of lung adenocarcinoma (ADC), and 152 cases of small cell lung carcinoma (SCLC). The TP cytology revealed a total of 460 cases of lung cancer (including 232 SCCs, 91 ADCs, and 108 SCLCs). The TP cytological technique had 87.06% sensitivity and 62.93% specificity in the diagnosis of lung cancer. Specifically, TP cytology confirmed 195 of 223 SCCs, 47 of 77 ADCs, and 94 of 152 SCLCs. The TP cytology showed 87.44% sensitivity and 90.05% specificity for the diagnosis of SCC, with a Matthew's correlation coefficient (MCC) of 0.820; while the sensitivity was reduced to 61.04% and the specificity was 90.93% for the diagnosis of ADC, with a MCC of 0.464. For the diagnosis of SCLC, the sensitivity was 61.84% and the specificity was 96.84%, with a MCC of 0.648. Thus, this study demonstrated the usefulness of TP bronchial brushing cytology in the early diagnosis of lung cancer, especially the early stage of lung SCC. A prospective clinical trial will verify these data before being translated into the clinic.
Highlights
Lung cancer is the most significant worldwide health problem and contributes to 30% of male and 26% of female cancer-related deaths, and approximately 1.38 million people die of lung cancer each year [1,2]
58.6% of patients with small cell lung carcinoma (SCLC) were in the limited stage, and 41.4% of them were in the extensive stage
We assessed the diagnostic value of TP bronchial brushing cytology in lung cancer in comparison to the corresponding histological diagnosis in each of 595 patients with suspicious lung cancer who underwent a fibro bronchoscopy
Summary
Lung cancer is the most significant worldwide health problem and contributes to 30% of male and 26% of female cancer-related deaths, and approximately 1.38 million people die of lung cancer each year [1,2]. The utility of TP of lung cell samples has been widely accepted as a major diagnostic method in various clinical settings and has been proven to have a great association with tissue histological diagnosis [8,9,10,11] The advantages of this method include improved visualization of diagnostic cells; uniform thickness of cytology slides, better cellular preservations, removal of air-drying artifacts, and elimination of obscuring blood and inflammatory exudate [12]. It does have a disadvantage; for example, malignant cells inside the hemorrhagic body-cavity effusions could be visualized as tissue fragments and may be removed by the TP processor. The aim of the current study was to compare the diagnostic value of TP bronchial brushing cytology in lung cancer to the corresponding histological diagnosis in each of 595 patients with suspicious lung cancer who underwent a fibro bronchoscopy
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