Sputum Cytology

Abstract

I enjoyed reading the article entitled "Approach to the Solitary Pulmonary Nodule," by Midthun and colleagues in the April 1993 issue of the Mayo Clinic Proceedings (pages 378 to 385). I was surprised, however, to note that the simplest clinical test for determining whether a solitary pulmonary nodule is malignant was not mentioned in the article. Sputum cytology is the most costeffective test available, and a positive diagnosis of malignant disease can have a 95% accuracy. In addition, I am sure that literally thousands of lung lesions have been diagnosed as malignant by sputum examination at the Mayo Clinic during the past century. Thus, I obviously wondered why this test was not mentioned. Sputum cytology was used in the National Cancer Institute study1 and was considered, at that time, "state of the art," but sputum diagnosis has improved tremendously with the experience obtained from fine-needle aspiration of lung lesions. This improvement has been demonstrated by several articles that have been published since the National Cancer Institute study.2"9 Therefore, sputum cytology is the most cost-effective, noninvasive procedure when findings are positive and should be the first test performed after a solitary pulmonary nodule has been detected roentgenographically.

Analysis of MicroRNAs in Sputum to Improve Computed Tomography for Lung Cancer Diagnosis

“…18,27–29 If this was unsuccessful, participants underwent sputum induction. A variation of the ultrasonic nebulization technique described by Saccomanno 9,10 was used for sputum induction. Participants inhaled a nebulized 3% saline solution from an ultrasonic nebulizer for 20 minutes.…”

“…9–11 Sputum contains airway epithelial cells. Analysis of sputum can indicate the specific source of the abnormal airway epithelial cells in the lungs, thus providing an organ-specific approach for lung cancer diagnosis.…”

Analysis of aberrant methylation on promoter sequences of tumor suppressor genes and total DNA in sputum samples: a promising tool for early detection of COPD and lung cancer in smokers

“…All patients and the control subjects underwent sputum induction, using the ultrasonic nebulization technique previously described [31]. Briefly, inhalation time was 2 min, followed by oral cleaning with water to avoid contamination with postnasal drip or saliva and drying of the mouth, and subsequent sputum expectoration over a period of 3 min.…”

Smoky coal exposure, NBS1 polymorphisms, p53 protein accumulation, and lung cancer risk in Xuan Wei, China

“…A series of five sputum samples were collected by spontaneous expectoration before surgery or any other type of treatment. Sputum was stored in 40 ml of Saccomanno's fluid [13]. The Saccomanno blending technique [13] was used to prepare the sputum samples prior to staining with Papanicolaou's reagent and p53 protein immunohistochemistry.…”

“…Sputum was stored in 40 ml of Saccomanno's fluid [13]. The Saccomanno blending technique [13] was used to prepare the sputum samples prior to staining with Papanicolaou's reagent and p53 protein immunohistochemistry. Eight slides were made for each subject.…”