Multitarget fluorescence in situ hybridization assay for the detection of lung cancer in bronchial cytology specimens: A Comparison With Routine Cytology.

Abstract

Routine bronchial cytology is an important diagnostic tool in suspected lung cancer. The purpose of this study is to evaluate the performance of LAVysion FISH assay over routine cytology for the detection of malignant bronchial cytology specimens. Forty six patients who underwent bronchoscopic examination in a period of 6 months were included. Bronchial brushing and/or washing specimens were accompanied by concurrent endobronchial biopsy and/or FNA, which were used as gold standard for diagnosis. The smears for FISH assay were made from the discarded residual fluid after being processed for routine cytology. Twenty seven of the 46 patients were diagnosed of malignancy. For bronchial brushing specimens, the sensitivity of routine cytology and FISH for the detection of malignancy was 18% (3/17) and 35% (6/17) respectively (p = 0.08); the specificity of routine cytology and FISH was the same, 80% (8/10). For bronchial washing specimens, the sensitivity of routine cytology and FISH for the detection of malignancy was 8% (2/24) and 29% (7/24) respectively (p = 0.01); the specificity of routine cytology and FISH was the same, 94% (16/17). Our data shows that routine bronchial cytology appears to have a very low sensitivity for the detection of malignancy. FISH assay appears to increase the sensitivity for the detection of malignancy, but does not appear to improve it to a desirable level. A larger prospective study is necessary to further evaluate the role of FISH assay in the detection of malignancy in bronchial cytology specimens.