Can semi-automated image cytometry on induced sputum become a screening tool for lung cancer?

Abstract

The correlations between semi-automated sputum cytometry (ASC), conventional cytology and the final diagnosis was investigated in industrially-exposed workers. Slides of sputum samples from 201 former uranium miners with silicosis, 100 patients with asbestosis, 103 workers resected for lung cancer, and 200 controls (50% smokers), were stained using the Papanicolaou (Pap) method and the Feulgen reaction with thionin. Cytometry was performed using the Cyto-Savant automated system. Atypical nuclei were found in 72 of 404 patient samples, 327 samples were normal and five were inadequate for ASC analysis. Thirteen tumours (Pap IV, Pap V) and 11 cases of severe dysplasia were identified by cytology. Lung cancer was confirmed in 20 patients. Compared to the final diagnosis of lung cancer, the sensitivity of ASC was 75% (15 out of 20) and specificity 89.8% (520 out of 579). The results represent a diagnostic efficiency of 89.3%. The combination of ASC with cytology increased sensitivity to 80% (16 out of 20) without significant loss of specificity (89.7% or 523 out of 581).In this investigation of a limited number of patients with occupational radon or asbestos exposure, semi-automated sputum cytometry appears to be sensitive and reliable for the detection of malignant changes in the tracheobronchial mucosa. Together with conventional cytology, it would be reasonable to test the validity of the combined methods in a large-scale feasibility study of early lung cancer detection. Eur Respir J 2001; 18: 942-950.

Induced sputum in occupational lung diseases

“…In a study by MAREK et al [23], semi-automated sputum cytometry appeared to be sensitive and reliable for the detection of malignant changes in the tracheobronchial mucosa in a limited number of patients with occupational radon or asbestos exposure. Together with conventional cytology, the authors stated that it would be reasonable to test the validity of the combined methods in a large-scale feasibility study of early lung cancer detection.…”

Incremental Value of Pulmonary Function and Sputum DNA Image Cytometry in Lung Cancer Risk Prediction

“…Several studies have reported that SDIC and automated SDIC improve sensitivity of detection of lung cancer over conventional pathology-based cytology and suggest that SDIC might be useful for early detection of lung cancer (24,(29)(30)(31)(32)(33)(34)(35). The extent to which SDIC data can improve lung cancer risk prediction is unclear.…”

Diagnosing intra-abdominal malignancy

“…In another study, Marek et al performed a multiinstitutional analysis in five countries, using semi-automated sputum cytometry, and found a sensitivity of 75% and a specificity of 98%. 41 The findings of these two groups were similar, so that this type of analysis might be useful for lung cancer screening in the future. However, confirmation of these studies in an independent test set, where the technical procedure is kept identical, is necessary.…”