Application of ThinPrep Bronchial Brushing Cytology in the Early Diagnosis of Lung Cancer: A Retrospective Study

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.

Detection of EML4-ALK in Lung Adenocarcinoma Using Pleural Effusion with FISH, IHC, and RT-PCR Methods

“…The therapeutic approach to lung cancer has changed dramatically in recent years with the widespread use of molecular testing, optimized to identify molecular targets for biological drugs [ 15 – 18 ]. Approximately 70% of patients with NSCLC are in the late stage of the disease, and for these patients, the only pathological material available for molecular testing may be cytological specimens [ 19 – 22 ]. Pleural effusion is observed in 7%–15% of lung cancer patients, and can be obtained noninvasively and more often than samples of the primary lesion.…”

Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations

“…However, smear preparations have several shortcomings such as variable specimen thickness, nonuniformity of slides, preparation and fixation artifacts, overlapping cellular material, obscuring elements such as mucus, inflammation, and blood, and poor cellular preservation. [239] Recent advances in cytopathological techniques include the development of liquid - based cytology (LBC) and cell - block (CB) preparation. The diagnostic yield of LBC is considered either higher or at least comparable to the conventional smears.…”

Comparison of conventional smear and liquid-based cytology preparation in diagnosis of lung cancer by bronchial wash and transbronchial needle aspiration

“…Studies have been done to compare the utility of TP over other preparations in respiratory tract cytology with superior results with the LBC. [ 13 14 15 16 17 18 ] We did not find increased diagnostic yield of TP in comparison to conventional smear preparations [ Table 1 ].…”