Diagnostic accuracy of cytology and biopsy in primary bronchial carcinoma.

Payne, Christopher Rowland; Stovin, P. G. I.; Barker, V; McVittie, S; Stark, J. E.

doi:10.1136/thx.34.3.294

Cited by 53 publications

(23 citation statements)

References 7 publications

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“…Fluoroscopic guidance was used as described previously.2 The material obtained was examined by the same cytopathologist (VB) and classified as being malignant, as showing a specific benign condition such as a hamartoma, or as showing "no evidence of malignancy." Tumours were subdivided into five groups: (I) squamous carcinoma; (2) adenocarcinoma; (3) undifferentiated tumour; (4) small cell tumours; (5) other tumours.…”

Section: Methodsmentioning

confidence: 99%

Use of percutaneous needle biopsy in the investigation of solitary pulmonary nodules.

Penketh

Robinson²,

Barker³

et al. 1987

Thorax

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Section: Methodsmentioning

confidence: 99%

Use of percutaneous needle biopsy in the investigation of solitary pulmonary nodules.

Penketh

Robinson²,

Barker³

et al. 1987

Thorax

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“…It could be argued that our biopsies were not truly representative of the tumour. However, SCC can be diagnosed with a high degree of accuracy even in non-surgical specimens if diagnostic criteria for squamous differentiation (keratin, intercellular bridges) are strictly adhered to [6][7]. The histological appearances in this case were quite clearly indicative of a squamous origin.…”

Section: Discussionmentioning

confidence: 75%

A 50-yr-old female with cough and exertional breathlessness

Mukherjee

Nanda

Green

et al. 2004

Breathe

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A 50-yr-old female primary school teacher presented with a 4-month history of cough, productive of scanty mucoid sputum without any haemoptysis. Her general practitioner had treated her with antibiotics, inhaled steroids and inhaled bronchodilators without effect. She then gradually developed progressive exertional breathlessness, particularly on climbing stairs. There was a history of occasional wheezing. She denied any history of nocturnal cough, orthopnoea or ankle swelling. She also complained of tiredness but no weight loss. There was no history of eye, joint or skin problems. The patient was a life-long non-smoker with no history of exposure to industrial dust or asbestos. She kept a dog but never kept birds. There was no history of recent foreign travel. ExaminationOn examination, she was comfortable at rest. There was no tachypnoea, finger clubbing, lymphadenopathy or cyanosis. The jugular venous pressure was normal and there was no ankle oedema. Her heart rate was 80 beats·min -1 and regular, and heart sounds were normal. Respiratory system examination revealed no tracheal deviation and normal percussion notes bilaterally. On auscultation, there were scanty crackles and occasional wheezes, particularly on the right mid zone. The remainder of the physical examination was normal. Oxygen saturation was 94% on air and she desaturated to 88% on exercise. InvestigationsInitial investigations revealed the following: haemoglobin 169 g·L , anti-nuclear antibodies and rheumatoid factor were negative, and serum angiotensin convertase was 30 U·L -1 . Chest radiography was performed ( fig. 1).

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“…From the remaining 745 samples, all high-grade dysplasia (moderate and severe) cases were also removed from the analysis (98 cases, Table 1), while all mild dysplasias were treated as negatives. As previous work has shown, the establishment of a reference diagnosis for pulmonary dysplasia is problematic due to very high interand intraobserver variability (26). Although the dysplasia cases remain of considerable interest for clinical applications, our first goal was to determine the comparative accuracy of the various sputum tests by using the most certain reference diagnoses available.…”

Section: Data Analysis Of Test Setmentioning

confidence: 99%

Increase of sensitivity of sputum cytology using high‐resolution image cytometry: Field study results

Palcic

Garner

Beveridge³

et al. 2002

Cytometry

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Lung cancer remains the leading cause of cancer deaths in the developed world. There is no widely accepted method to screen for this cancer. The most commonly used method remains conventional sputum cytology, but this method is hampered by low sensitivity. We tested the hypothesis that sensitivity of sputum cytology for early lung cancer can be greatly improved by using image analysis of sputum cells, at a modest reduction of specificity.The study was double-blinded and used sputum samples from subjects with well-characterized clinical diagnoses. There were 177 cancers, 98 dysplasias, and 558 normals. The study samples were separated into two independent sets: training set and test set. Sputum samples were collected prospectively from subjects with a high probability of having lung cancer. Seven institutions from five countries participated in the study. All subjects had complete clinical diagnoses which included, as a minimum, negative chest x-rays for all negative cancers, while all cancers had confirmed tissue pathology. Samples were prepared according to the Saccomanno method. For conventional cytology, slides were stained using Papanicolaou stain. For image analysis, slides were stained using a DNA-specific (Feulgen-Thionin) stain. An automated, high-resolution image cytometer was used for measurements.At 90% specificity, sensitivity of 60% can be achieved for adenocarcinoma, compared to only 14% sensitivity of conventional cytology (at 99% specificity). Similarly, 45% sensitivity at 90% specificity can be reached for stages 0 and I lung cancer, compared to only 14% (at 99% specificity) using conventional cytology.Cytometry combined with conventional cytology shows an increase in sensitivity to early-stage cancer and to adenocarcinomas compared to conventional cytology alone. While the results are encouraging, the sensitivity to detect early lung cancer should be further improved to 70 -80% at 90 -95% specificity before this test can be considered for screening of high-risk individuals for lung cancer. Cytometry (Clin. Key terms: lung cancer; sputum cytology; image analysis; sensitivity; specificity; screening for lung cancer; early lung cancer; adenocarcinoma Despite the fact that advances have been made in sputum cytology over the last 30 years (1,2), the literature contains mixed results about the efficacy of using it as the primary method for detection of lung cancer. Although approximately 50 studies employing a range of preparation techniques reported sensitivities ranging from 40 -80% at high specificities (95-99%) (3), they suffer from a limited number of samples and are demonstrated by latestage cancer. Large-scale studies, such as the NCI-sponsored study (the Cooperative Early Lung Cancer Detection Program, carried out by Memorial Sloan-Kettering, the Mayo Clinic, and Johns Hopkins University) (4 -6), did not confirm such results despite the fact that the most experienced cytopathologists of the day were carrying out the sputum cytology. Sputum cytology alone detected only 23% of the cancers in th...

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Diagnostic accuracy of cytology and biopsy in primary bronchial carcinoma.

Cited by 53 publications

References 7 publications

Use of percutaneous needle biopsy in the investigation of solitary pulmonary nodules.

Use of percutaneous needle biopsy in the investigation of solitary pulmonary nodules.

A 50-yr-old female with cough and exertional breathlessness

Increase of sensitivity of sputum cytology using high‐resolution image cytometry: Field study results

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