Sputum Cytology Research Articles

Using induced sputum method in clinical practice in patients with bronchial asthma

This article presents an overview of modern statements of the induced sputum method; detailed description of the methods and protocols for taking sputum in adults and children, methods for processing the obtained substance. The paper describes in detail the features of the cellular composition of induced sputum in healthy individuals and in patients with bronchial asthma, emphasizes the importance of the eosinophilia level as a prognostic and diagnostic criterion of asthma and also determines the functions of other induced sputum cells such as neutrophils, macrophages, basophils. The article is illustrated with photographs of sputum microscopy. In addition to sputum cytology, we give accent to the possibility of using other research methods such as an identification of viral and bacterial pathogens, genomics, proteomics, lipidomics, metabolomics, determination of the concentration of various mediators in the sputum supernatant. The paper presents the ideas on biochemical inflammatory markers and remodelling of the respiratory tract in asthma, which can be determined in sputum (C3a anaphylatoxin, clusterin, periostin, eosinophil-derived neurotoxin, folliculin). In addition, we summarize the information on inflammatory phenotypes of bronchial asthma, emphasize their variability and modification depending on the period of the disease, prescribed treatment, intercurrent respiratory infections, and smoking. The article also presents detailed characteristics of eosinophilic, neutrophilic, mixed and small granulocyte phenotypes of bronchial asthma, and describes the most frequent correlations of phenotypes with the severity and course of the disease, with lung function parameters and other indicators. The paper gives an account of the possibilities of using the induced sputum method for a comprehensive assessment of the course, asthma controllability and the effectiveness of drug therapy, as well as for a personalized selection of an antiinflammatory drug considering the inflammatory phenotype.

Fungal Elements in Sputum Cytology Among Active and Post_Treated Pulmonary Tuberculosis Patients in Al Managil Teaching Hospital, Gezira State, Sudan (2020)

Sputum cytology is still one of the most effective and producible sample for diagnosis and evaluation of lung diseases and disorders. For this, it can used for evaluation of apportunistic fungal pathogens on pulmonary tuberculosis patients, which is of leading cause of death worldwide. On this cross sectional laboratory base study, which used to evaluate the sputum cytology for presence of opportunistic fungal elements. A total 110 early morning expectorate sample collected from the period 1/3 to 30/6/2020. 69/110 (63%) from patients come for first diagnosis to the center of T.B and HIV. Al Managil teaching hospital, and 41/110 (37%) follow-up starting from second month until six month post- treated follow up. From each sample two slides was prepared. One of them fixed immediately before air-drying in 95% ethanol and later stain by PAS technique, the other fixed after air-drying on absolute methanol and stain by Giemsa stain. Regardless to other method of fungal identification such as serology or mycological culture, only depends on microscopic identification. The study found that 95/110 (86%) was negative for fungal elements, and 15(14%) was positive, 9(8%) positive in diagnosis group and 6(5%) in follow-up group. Moreover the most common infectious agents was Candida species 9/110 (8%), 6/110 (5%) present as yeast and 3/110 (2%) as Pseudohyhae. Followed by Aspergillus species 5/110 (4%) then actinomyces species 1/110(.9%). The incidence of infection is higher in rural (82%) males (55%) farmers (36%). In the majority of the pateints with negative results for fungi MDR-TB not detected 87(79%), followed by positive for fungi and also MDR-TB not detected 15 (13.6%), then (negative and positive) for fungi and MDR-TB with high rate with the same percentage 3(2.8%), and finely very low MDR-TB 1(.9%), medium MDR-TB 1(.9%) without any detection of fungal elements. The study recommended including fungal testing and antifungal drugs on the pulmonary TB treatment plan as possible causes of complications.

To study the role of sputum cytology in patients with bronchial asthma and COPD

COPD is the major cause of morbidity and mortality across the world. In addition to this, the major factor that is contributing in this disease is smoking. This kind of problem occurs due to airflow obstruction that influences the progressive and accompanied hyper-responsiveness. The patients with Asthma and COPD overlap (ACO) have a poor quality of life and more rapid decline in lung functions and high mortality. Also, they consume a disproportionate amount of health care resources. Moreover, sputum cell counts are extensively used in the treatment of asthma and COPD. The clinical application of sputum cell count in patients with both COPD and asthma remain elusive. The study aims to study the role of sputum cytology in patients with Bronchial Asthma and COPD. It was a prospective study carried out in the Department of Pulmonary Medicine, D Y Patil Medical College, Nerul, Navimumbai, Maharashtra, India. The period of the study was from January 2020 to June 2021. The number of healthy patients recruited for the current study was 20, along with 20 asthmatic patients and 30 COPD patients. Spirometry and body plethysmography was used to measure the capacity and volume of the lungs of all the patients. One-Way Analysis of Variance (ANOVA) test was conducted for counting the differences in counts of lung function variables and sputum cells. The mean age of healthy patients was 62.78±6.1 years, asthmatic patient was 55.9±12.8 years and COPD patients was 65.8±5.2 years. According to the analysis, the specific airway's conductance for aesthetic patients was [0.60±0.04 kPa.Sec⁻¹] and for the patient who was suffering from COPD, the score was [1.82±0.19 kPa.Sec⁻¹] and the outcome for healthy patients was [1.19±0.12 kPa.Sec⁻¹].The study has found a strong relationship between sGaw and neutrophil and the neutrophil-macrophage ratio of COPD patients. According to the analysis of the study outcome, eosinophils are important for the respiratory inflammatory infiltrates in asthma patients as well as in COPD.

Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality.

Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality.

Influence of epidemiological factors on asthma phenotypes among asthma patients attending a tertiary care center – A cross-sectional study

Background: Asthma is a heterogeneous disease presenting with various phenotypes usually characterized by chronic airway inflammation. Aims and Objectives: The aim of the study was to identify epidemiology of bronchial asthma phenotypes in patients attending totertiary care center. Materials and Methods: This was a descriptive cross-sectional study involving 69 patients who are suspected to have asthma according to the Global Initiative for Asthma guidelines. The data of each patient were collected on a proforma specially designed for this study on demographic data, socioeconomic status, body mass index, exposure to environmental factors, and other history-related questions. Sputum cytology and absolute eosinophil count were also examined using coGuide and P<0.05 was considered significant. Asthma phenotypes were the primary outcome and association of environmental factors with asthma phenotypes was the secondary outcome. Results: Out of 69, majority 26 (37.7%) were aged 31–40 years; 35 (50.7%) males and 34 (49.3%) were females. Fifty-eight (84.1%) were illiterate and 46 (66.7%) belonged to low class. Sputum cytology report showed that majority of them, 66.7%, had eosinophilia. The majority, 48 (69.6%), of the participants were triggered by weather and 55.1% had a history of respiratory tract infections. Thirty-three (47.83%) participants had obesity associate asthma, 34 (49.28%) had allergic asthma, and 20 (28.99%) had smoking-related asthma phenotypes. The difference in the proportion of few environment factor was significant for allergic and smoking-related asthma (P>0.005). Conclusion: The factors associated with the asthma phenotypes will help us further in anticipating the clinical course and better management of the specific phenotypes.

Usefulness of post-bronchoscopic sputum cytology with respect to bronchoalveolar lavage and brush cytology using fiber-optic bronchoscopy in suspected cases of lung cancer

Background: Bronchogenic cancer is the most common cause of cancer-related mortality in both sexes all over the world, especially across urban population. However, early diagnosis and timely intervention may minimize the mortality rate to a certain extent and increase the 5-year survival rate to 70–80%. Among the diagnostic modalities available, bronchoscopic biopsy, though gold standard, is less feasible in peripheral centers where we depend more on cytological techniques such as bronchoalveolar lavage (BAL) fluid and sputum cytology for quick diagnosis. Aims and Objectives: This study was conducted at a tertiary care center for studying usefulness of post-bronchoscopic sputum cytology and also to correlate sputum cytology with brushing and washing cytology taking biopsy as the gold standard in the diagnosis of lung cancer. Materials and Methods: A cross-sectional observational study was done in Nil Ratan Sircar Medical College, Kolkata, over a period of 18 months in clinically and radiologically suspected patients of bronchogenic carcinoma. Bronchoscopic samples using a fiber-optic bronchoscope were collected from 50 such patients. In every case, following sequence of events was performed: Pre-biopsy washing (BAL fluid), brushing, biopsy, post-biopsy washing (BAL), and post-bronchoscopy sputum. Cytological examination done and compared with bronchoscopic biopsy specimens of the same. Results: All the available information were meticulously documented in tables and charts along with other variables such as age, sex, morphological types, and cytological and histological diagnosis. SPSS software was used to calculate the efficacy and statistical significance, if any, of these different diagnostic tools and its correlation with the final histological diagnosis. Conclusion: We found that BAL cytology had higher sensitivity and positive predictive value in early and accurate diagnosis of lung malignancy. However, post-bronchoscopy sputum cytology had no additional benefit with respect to BAL and brush cytology (in addition to bronchial biopsy) in diagnosing the same.

Comparative evaluation of Ziehl- Neelsen staining and kinyoun’s staining in the diagnosis of clinically suspected cases of tuberculosis

: Tuberculosis commonly affects lungs but can also be ex­tra-pulmonary. The increasing prevalence of extra-pulmonary manifestation of tuberculosis is a cause for concern. Microbiological diagnosis is essence for the effective treatment of mycobacterium tuberculosis. The smear detection tests differentiate infectious from non-infectious cases. Both Ziehl-Neelsen (Z-N) and kinyoun stain (KC) methods are over 100 years old; these are most economical in terms of processing time, needed equipment and personnel. The objective of research was to evaluate the two smear microscopy methods for the detection of tubercle bacilli in the sputum and Fine needle aspiration cytology (FNAC) material by comparing the sensitivity, specificity and validities of kinyoun’s method against Z-N staining.A prospective and comparative study was carried using 500 sputum samples and 100 FNAC material received in the department. All the 600 samples were subjected to two methods:Z-N stain and Kinyoun’s cold stain. They were compared for sensitivity and specificity in terms of qualitative results and grades of smear as recommended by RNTCP. : The smear positivity rate was 18% and 20.16% in Ziehl-Neelsen stain and Kinyoun’s cold stain respectively. The direct smear microscopy for Z-N staining showed sensitivity, 89.25%, specificity and positive predictive value (PPV) 100% and negative predictive value (NPV) 97.35% whereas KC method showed sensitivity 98.37%, specificity and PPV 100% and NPV 99.58% respectively. Kinyon’s method described is slightly longer to perform than the Ziehl-Neelsen technique but its ease of use and equal efficacy with Z-N method make it universally applicable, especially in those laboratories where facilities are poor.

Preliminary Results of NGS Gene Panel Test Using NSCLC Sputum Cytology and Therapeutic Effect Using Corresponding Molecular-Targeted Drugs.

As more molecular-targeted drugs for advanced non-small cell lung cancer are brought to market, batch tests for the identification of gene mutations are needed at initial diagnosis. However, since current gene panel tests require a sufficient amount of tissue sample, there are many instances where panel tests cannot be performed. Therefore, we have developed a highly sensitive next generation sequencing (NGS) panel test to facilitate cytological specimens. Herein, we describe three cases positive for epidermal growth factor receptor (EGFR) exon 19 deletion, MET exon 14 skipping, and KRAS G12A using NGS analysis from sputum. In each case, genetic information was consistent with companion diagnostic analysis obtained from tissue samples collected under bronchoscopy. In cases of EGFR and MET mutations, the corresponding tyrosine kinase inhibitors were highly effective. This is the first report to demonstrate that a novel panel test could detect gene mutations in sputum samples in clinical practice and compare the gene allele ratio with the sample directly collected from the lesion.

Analyses of lung cancer-derived volatiles in exhaled breath and in vitro models.

Lung cancer is one of the leading causes of cancer incidence and cancer-related deaths in the world. Early diagnosis of pulmonary tumors results in improved survival compared to diagnosis with more advanced disease, yet early disease is not reliably indicated by symptoms. Despite of the improved testing and monitoring techniques for lung cancer in the past decades, most diagnostic tests, such as sputum cytology or tissue biopsies, are invasive and risky, rendering them unfeasible for large population screening. The non-invasive analysis of exhaled breath has gained attentions as an innovative screening method to measure chemical alterations within the human volatilome profile as a result of oncogenesis. More importantly, volatile organic compounds (VOCs) have been correlated to the pathophysiology of disease since the source of volatile compounds relies mostly on endogenous metabolic processes that are altered as a result of disease onset. Therefore, studying VOCs emitted from human breath may assist lung cancer diagnosis, treatment monitoring, and other surveillance of this devastating disease. In this mini review, we evaluated recent human studies that have attempted to identify lung cancer-derived volatiles in exhaled breath of patients. We also examined reported volatiles in cell cultures of lung cancer to better understand the origins of cancer-associated VOCs. We highlight the metabolic processes of lung cancer that could be responsible for the endogenous synthesis of these VOCs and pinpoint the protein-encoding genes involved in these pathways. Finally, we highlight the potential value of a breath test in lung cancer and propose prominent areas for future research required for the incorporation of VOCs-based testing into clinical settings.

A New Method for the Sputum Cytology Test Without Direct Contact to Specimens During COVID-19 Pandemic.

BackgroundCoronavirus disease 2019 (COVID-19) pandemic continues to spread across the world. Specimens of blood, body fluids and excreta received in the department of pathology undoubtedly increased the risk of infection, especially in some hospitals that are short of professional protection capability. Here we provided a new simple way for the sputum cytology test during the COVID-19 pandemic.MethodsSputum samples from 30 patients with lung cancer were collected and divided into two groups, including the control group and the experimental group. Samples of the control group were processed in the biological safety cabinet, while the experimental group was put into the sealed specimen bag directly and pretreated with 75% medical alcohol. Then the cell morphology and tumor cell identification were analyzed by cell smears and liquid-based cell staining. The expression of cell antigens was determined by immunohistochemical staining.ResultOur result showed that both sputum samples in two groups exhibited complete cell structure and clear morphology according to the cell smear and liquid-based cell staining. In addition, the immunohistochemical result showed that cell antigens, including cytokeratin (CK), leukocyte common antigen (LCA), and thyroid transcription factor-1 (TTF1), were specifically expressed in the cell membrane, cytoplasm, and nucleus, respectively. The tumor cells were distributed diffusely, and cell antigens were located accurately after pretreatment with 75% medical alcohol and were consistent with that of the control group.ConclusionUsing 75% medical alcohol to pretreat sputum specimens has no obvious impact on cell morphology and antigens expression. Our study provided a new method for the sputum cytology test with no direct contact so as to protect medical staff against the virus during COVID-19 outbreak.

The Role of Tissue and Liquid Biopsy in the Clinical Management of Adult Lung Cancer Patients in King Abdul-Aziz Medical City in Riyadh, Saudi Arabia.

BackgroundLung cancer is the most fatal malignancy worldwide, characterized by uncontrolled growth in the tissue of the lung(s). The diagnosis of lung cancer depends on the medical history of the patient, along with the physical examination, and various imaging studies. Furthermore, sputum cytology, thoracentesis, or a tissue and liquid biopsy can be examined. The TNM (tumor size, lymph nodes, and metastasis) system is used for staging and grading lung cancer. This study aimed to evaluate the role of tissue vs liquid biopsy in the clinical management of adenocarcinoma, at King Abdulaziz Medical City, Riyadh.MethodsIn this cross-sectional study, all adenocarcinoma patients treated between January 2016 to December 2018 were included using consecutive sampling. The participants were ≥ 18 years old patients with histologically confirmed adenocarcinoma (stage IIIb/IV) regardless of the mutation status. This data was collected through chart review. Data analysis was performed using the IBM Statistical Software for Social Sciences (SPSS) software, version 22 (IBM SPSS Statistics for Windows, Armonk, NY). ResultsA total of 58 participants were included in the analysis. All of them had undergone a tissue biopsy, while only 16 patients underwent liquid biopsy. Out of all patients, 26% of patients had tissue biopsy-related complications (TBRC), with pneumothorax being the most common complication. Single gene testing for epidermal growth factor receptor (EGFR) for patients who underwent tissue biopsy showed a 35% mutation rate. For the anaplastic lymphoma kinase (ALK) gene, 13% were found to be mutated; for the ROS proto-oncogene 1 (ROS1) gene, only 7% were seen to be mutated. For a panel of 12 genes, 25% had the tumor protein 53 (TP53) gene mutation and 39% had the gene Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations. For patients who underwent a liquid biopsy, 20% had the TP53 mutation, 43% had the EGFR mutations on a single gene test and 42% on a panel test, and 10% had the KRAS mutation.ConclusionWe found that tissue and liquid biopsy showed genetic mutations, particularly with EGFR, TP53, and KRAS genes, among adenocarcinoma patients. Identifying genetic changes in adenocarcinoma patients is essential for charting a targeted therapy. Primary EGFR mutations and rearrangements of ALK or ROS1 are the only gene mutations that can be done with specific tyrosine kinase inhibitors available for clinical practice. Therefore, we recommend further studies to evaluate the role of tissue and liquid biopsy in clinical practice.

Chronic obstructive pulmonary disease due to aerosols containing nanoparticles: inflammation and phenotype features

Introduction. Influence of incidental nanoparticles of industrial aerosols on occupational lung diseases development is not studied enough. As nanoparticles has properties to induce inflammation and fibrosis, it is hypothesized that they affect occupational chronic obstructive pulmonary disease (COPD) phenotype. The aim was to establish monocyte subsets, airway inflammation, clinical and functional features in occupational COPD due to aerosols containing nanoparticles exposure. Materials and methods. Study design was a single center prospective cohort observational. Subjects with occupational COPD (GOLD 2011-2021 criteria) exposed to aerosols containing nanoparticles (n=50) enrolled. Comparison group - COPD in tobacco smokers (n=50), control group - healthy people (n=50). Groups were matched by demographics and COPD duration. Nanoparticles at workplaces air were measured by inductively coupled plasma atomic emission spectrometry and by scanning electron microscopy. Of participants 26 were exposed to maximal concentrations of metal nanoparticles and 24 - of silica nanoparticles. Spirography, body pletysmography, lung diffusing capacity (DLco/Va), Doppler-ehocardiography, induced sputum cytology, COPD exacerbations assessment were done. Monocyte subsets were determined by flow cytometry. Linear regression model was used to explore relationships. Results. COPD due to aerosols containing metal nanoparticles was characterized by most severe airflow limitation, lung hyperinflation, pulmonary hypertension, most prominent decrease in DLco/Va, frequent and severe COPD exacerbations, eosinophilic inflammation. The largest proportion of «classical» CD14+CD16- monocytes subset, 96,4% (90,3%; 97,2%), high level of CCR5 expression were seen in this group. The features of COPD due to aerosols containing silica nanoparticles were substantial decrease in DLco/Va, the least airflow limitation, mild lung hyperinflation, rare COPD exacerbations, paucigranulocytic inflammation. The largest proportion of «non-classical» CD14DimCD16+ monocytes with high level of CCR2 expression revealed. Mass concentration of metal nanoparticles was associated with «classical» monocytes, (B=1,5), silica nanoparticles - with «non-classical» monocytes (B=1,4). On their turn, «classical» monocytes were associated with DLco (B=-1,6), functional residual volume (B=1,2), mean pulmonary artery pressure (B=-1,4), eosinophilic inflammation. «Non-classical» monocytes were associated with DLco (B=-1,5) and paucigranulocytic inflammation (B=1,2), p<0,015. Conclusions. Exposure of incidental nanoparticles was associated with circulated monocyte subsets, airway inflammation and occupaitonal CODP phenotype.

First case of lung cancer with pneumoconiosis and endobronchial leiomyoma complicating the diagnosis

BackgroundIn the treatment of lung cancer, the presence or absence of mediastinal lymph node involvement has a significant bearing on the indication for surgery. In addition, if a tumor is found in the trachea during preoperative scrutiny of lung cancer, the possibility of intratracheal metastasis should be considered, since this kind of metastasis is a contraindication for surgery. In the present study, we experienced a case of lung cancer associated with pneumoconiosis and a rare intratracheal leiomyoma. In this case, preoperative staging was difficult, but endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and intratracheal tumor biopsy were helpful in determining the treatment strategy.Case presentationA 65-year-old man was referred to our hospital for evaluation of abnormal chest X-ray shadows. Sputum cytology indicated squamous cell carcinoma. PET-CT scan showed fluorodeoxyglucose uptake in a right upper lobe mass and the hilar, mediastinal and right supraclavicular lymph nodes, and bronchoscopy revealed a protuberant lesion in the left bronchus. Hence, EBUS-TBNA for the mediastinal lymph nodes and simultaneous evaluation of the protuberant lesion in the left bronchus were performed. The bronchial tumor was histopathologically diagnosed as leiomyoma. Since mediastinal lymph node biopsy showed no malignant cells, a right upper lobectomy and a right S6 segmentectomy were performed. Postoperative pathological evaluation of the dissected lymph nodes revealed pneumoconiosis but no metastasis. He was, thus, diagnosed with squamous cell lung carcinoma (pT2bN0M0, pStage IIA).ConclusionsWe report a patient with lung cancer and coexistence of a rare endobronchial leiomyoma and pneumoconiosis, who underwent surgery after preoperative evaluation using EBUS-TBNA.

Inhaled corticosteroid response in smoker versus non-smoker asthmatic patients: a cross-sectional study

BackgroundAsthmatic smokers are a distinct phenotype of asthma. There is a lack of specific information about the treatment of asthma in smokers. The purpose of this study was to compare the effects of inhaled corticosteroid (ICS) on asthmatic smokers and non-smokers.ResultsThe present observational, cross-sectional study was conducted at the Chest Department in Assiut University Hospital, during the period from August 2018 to January 2020. Hundred and seventeen asthmatic patients (42 smokers, 30 ex-smokers, and 45 non-smokers) were assessed using an asthma control questionnaire (ACQ), spirometry, sputum cytology, and serum periostin and eotaxin-2 to compare between a patient on inhaled corticosteroid for at least 3 months and patients who do not receive any form of corticosteroid. Asthmatic smokers had poor response to ICS and had insignificant improvement as regard all parameters. However, asthmatic ex-smokers had a partial response to ICS. They had higher post-bronchodilator FEV1 in comparison to those who did not receive ICS. Asthmatic non-smokers on ICS showed the best response as they were well controlled as regard ACQ. Moreover, they had higher post-bronchodilator FEV1/FVC, post-bronchodilator FEV1, and post-bronchodilator FEF25-75, and lower sputum eosinophils and neutrophils.ConclusionSmoking adversely affects the course and response to ICS therapy in asthma.Trial registrationInterrelation between bronchial asthma and smoking: ClinicalTrials.gov ID: NCT03207620. Registered 27 June 2017.

A Prospective Observational Study between the Value of Sputum Cytology and FNAC of Bronchial Growth in Diagnosing Lung Cancer at Chattogram Medical College Hospital, Bangladesh

Background: Lung disease is viewed as perhaps the most far reaching and deadly malignancies all throughout the planet. The most seasoned and most crucial technique is based on sputum cytology. The last outskirts for getting sufficient material are fine needle yearning cytology (FNAC) of bronchial development. Aims and Objective: To relate the meaning of sputum cytology and fine needle goal cytology of bronchial tissue under CT rules for diagnosing cellular breakdown in the lungs. Materials and Methods: This potential observational investigation was completed by the division of medication in Chattogram Medical College Hospital, Chattogram, Bangladesh. Where data was collected from January 2019 to June 2020. A total of 50 patients with a suspected history, symptoms, and risk profile of having primary lung cancer, as demonstrated by chest radiography and CT scan, were chosen for the research population. Fifty patients with clinical and biochemical verification of suspected. All collected data were coding and input in SPSS-25 for further analysis. Both descriptive and inferential statistics were tested. Results: Among the 50 patients the vast majority of the patients were 51-60 years of age and the biggest number of the (94 %) patients were male. Sputum cytology is 8% touchy which isn’t steady with different examinations and CT guided FNAC is 94% sensitive. Conclusion: A definitive point of picture guided histological or cytological examination is to stay away from unnecessary thoracotomy and accomplish a particular determination with sensible exactness and least results. So, in this examination we found that sputum cytology is 8% delicate which isn’t steady with different investigations and CT guided FNAC is 94% touchy to last histological analysis of lung cancer. The discoveries recommended that CT guided FNAC discovered to be protected, feasible and viable.

Comparative Study of Gynaecological and Non-Gynaecological Samples Received in Igbinedi on University Teaching Hospital

Background: Gynaecological and non-gynaecological samples are two main types of cytological sample. The Gynaecological samples are usually Pap (cervical) smears, Vagina smear, Endocervical aspiration, Endometrial aspiration etc. Non-gynaecological samples fall into two categories, exfoliative and fine needle aspiration samples. The sample size of this study was 32 and was determined using the method of Naing, Winn, and Rusli, (2006).Aim: This study was aimed at comparing the efficacy of the gynaecological sample and non-gynaecological sample in a variety of parameters including cellular morphology, specimen preparation, screening time, and impact on the final result. Materials and methods: Gynaecological sample was obtained by introducing a spatula into the vagina with the aid of speculum. The cellular material obtained was rapidly but gently smeared on a clean glass slide and the smear made was fixed while it is wet for Papanicolaou staining and was cleared, mounted and studied microscopically. Non-Gynaecological sample – sputum was collected with a deep cough from the lungs early in the morning before eating and deposited directly into a preservative container. Air-dried smears were fixed in methanol for 15 minutes and rinsed in buffer. The smear was stained with May-Grunwald for 5 minutes and stained again with Giemsa for 10 minutes. The smear was differentiated in buffer and allowed to air dried, cleared in xylene and mounted with DPX.Results: This present study revealed that cervical casesoccurred more in younger age (30-39) when compared to non gynaecological cases (sputum) which occurred more in older adults (age group 50-59).Conclusion:Treating all cervical pre-cancers can prevent almost all cervical cancers. Cervical smear showed predominately parabasal and intermediate cell, esinophilic cells with increased nuclear/ cytoplasmic ratio and eccentric cells. However, the sputum cytology show basically cells with increased nuclear/ cytoplasmic ratio.

A study on specific learning algorithms pertaining to classify lung cancer disease

AbstractLung cancer is a worldwide precarious disease and it is encouraged by the abnormal growth of cells in bronchi. Spotting the cancer cells is unknown until it leads to respiration issues and the muddling of organs working. Due to problems, limited or incorrect selection of hypothesis space, and dropping into local minima, single learners often give erratic output in an existing approach. The ensemble method accomplished a dataset that is free and composed of computed tomography (CT) images. The annotation process reveals observed lung lesions and provides a degree of malignancy for each lesion. Detection of benign and malignant nodules is recognized using deep convolutional frameworks AlexNet, SqueezeNet, GoogleNet, ResNet, and Inception ResNet, achieves higher accuracy (93%) than other convolutional neural networks (CNNs). Eight machine learning methods are involved for achieving better performance. The prediction probability obtained from CNN is applied as input to support vector machines (SVM), K‐nearest neighbours (KNN), naive Bayes (NB), multi‐layer perceptron (MLP), decision trees (DT), gradient boosted regression trees (GBRT), and adaptive boosting. The composition of GoogleNet model and AdaBoost classifier reached the most coherent classification accuracy as 99%. This is one of the best ways to analyse early detection and it increases the survival rate. Therefore, the result from the proposed deep CNN and ML technique achieves better precision than sputum cytology, X‐Ray process, and earlier detection of lung cancer.

Sputum-Based Tumor Fluid Biopsy: Isolation and High-Throughput Single-Cell Analysis of Exfoliated Tumor Cells for Lung Cancer Diagnosis.

Timely and effective diagnosis is of great significance for improving the survival rate of lung cancer patients. Although histopathology is the main diagnostic tool among the existing methods for lung cancer diagnosis, it is not suitable for high-risk groups, early lung cancer patients, patients with advanced-stage disease, and other situations wherein tumor tissues cannot be obtained. In view of this, we proposed an innovative lung cancer diagnosis method employing for the first time a microfluidic technology for high-efficiency isolation and high-throughput single-cell analysis of exfoliated tumor cells (ETCs) in sputum. This method fully combines the advantages of traditional sputum cytology and microfluidic technology and realizes the diagnosis of lung cancer by using a small amount of repeatable ETCs instead of the tumor tissue. This method is expected to provide a practical strategy for the non-invasive detection of lung cancer patients and lung cancer screening for high-risk groups.

Respiratory cytology in malignant lung disease - The thoracic oncologist's perspective.

Respiratory cytology continues to play a central role in the diagnosis and staging of thoracic malignancy, although over time indications have changed. Historically, sputum cytology and endobronchial brushings and washings figured prominently, but with the advent of endobronchial and endoscopic ultrasound much greater emphasis is placed on fine needle aspirates from lymph nodes. The advent of targeted sequencing panels for genomic profiling to identify driver mutations and PD-L1 directed immunotherapy means that there is a need to extract increasing amounts of diagnostic and predictive information from ever smaller amounts of diagnostic material. Recent work has demonstrated that cytology samples are well suited to delivering the information required, but in order to understand the limitations of clinical and laboratory techniques, a close working relationship between pathologist and thoracic oncologist is needed to optimise sample procurement and utilisation.

Classification of non-acute bronchial asthma according to allergy and eosinophil characteristics: a retrospective study

BackgroundInvestigating the endotypes of the different asthma phenotypes would help disease monitoring, prognosis determination, and improving asthma management standardization. This study aimed to classify asthma into four endotypes according to the allergic and eosinophilic characteristics and explore the phenotypes (clinical characteristics, pulmonary functions, and fractional expired nitric oxide (FeNO)) of each endotype.MethodsThis retrospective study included non-acute asthma patients treated at the First Hospital of Shanxi Medical University (05/2016–01/2018). The patients were classified into the eosinophilic allergic, eosinophilic non-allergic, non-eosinophilic allergic, and non-eosinophilic non-allergic asthma endotypes. Serum sIgE, lung function, FeNO, and induced sputum cytology were tested and compared among groups.ResultsOf the 171 included patients, 22 had eosinophilic allergic asthma, 17 had eosinophilic non-allergic asthma, 66 had non-eosinophilic allergic asthma, and 66 had non-eosinophilic non-allergic asthma. Lung function measurements (FEV1%, FEF25%, FEF50%, FEF75%, and FEF25–75%) showed that airway dysfunction was worse in eosinophilic non-allergic asthma than in the other three endotypes (all P < 0.001). In allergic asthma patients, eosinophilic asthma had worse airway dysfunction than non-eosinophilic asthma (all P < 0.05). Similar results were found in non-allergic asthma (all P < 0.01). The FeNO levels in eosinophilic allergic asthma were higher than in eosinophilic non-allergic and non-eosinophilic non-allergic asthma (both P = 0.001).ConclusionsFeNO can objectively reflect eosinophilic airway inflammation in asthma. Endotypic classification of asthma patients regarding the allergic and eosinophilic characteristics is conducive to the effective management of patients with asthma.