Value of cytologic analysis of bronchial washings in lung cancer on the basis of bronchoscopic appearance

Lee, Gi Dong; Kim, Ho Cheol; Kim, You Eun; Lee, Seung Jun; Cho, Yu Ji; Jeong, Yi Yeong; Jeon, Kyoung-Nyeo; Jang, Inseok; Lee, Jong Deok; Hwang, Young Sil

doi:10.1111/j.1752-699x.2012.00293.x

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…10,11 However Lee GD et al and Shagufta TM et al obtained good diagnostic yield with BW which was at variance with this study. 9,12 In current study, in comparison to BW, BB gave a higher number of TP and TN and lesser number of FN cases, showing superiority of BB over BW. High percentage of FN with BW could be because of BW technique relies mainly on cells exfoliated from malignant lesion in bronchial epithelium and the adequacy of its samples depend on several factors especially preservation of morphology of cytological material obtained, degree of differentiation of malignant growth and technical skill of pulmonologist in performing washing in retrieving wash fluid.…”

Section: Discussionsupporting

confidence: 47%

Comparative study of bronchial brush and bronchial wash cytology in the diagnosis of lung tumors

Zainudeen¹,

Nair²,

Suhail³

et al. 2021

JDPO

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Cytological techniques are used as first line diagnostic tool in suspected lung tumors, based on which crucial management decisions are made. Bronchial brush (BB) and bronchial wash (BW) are two commonly employed techniques with variable diagnostic yield. This study compared the efficacy of BB and BW in diagnosing lung tumors. Aims: To study sensitivity of BW and BB cytology in diagnosing lung tumours by correlating with biopsy as gold standard. To study the efficacy of BW and BB in typing the lung tumors. Methods and Material: A cross sectional observation study for a period of 5 years was done. A total of 176 cases, suspected of lung cancer between January 2015 and December 2019 were selected, where cytology samples of BB or BW or both along with biopsy were obtained. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated separately for BB and BW. Statistical analysis used: All data were analyzed using SPSS software version 20. Results: Sensitivity of BB was significantly higher (77.8%) when compared to BW (51.9%), while specificity was better for BW (90.9%) compared to BB (80%). Positive predictive value of BW was higher (97.6%) compared to BB (93.3%). Negative Predictive value of BB and BW was 50% and 21.3% respectively. BB showed better accuracy (78.3%) compared to BW (56.85). Conclusions: BB is a much superior technique in diagnosing lung tumors, as it demonstrates far better sensitivity and accuracy. However, since specificity is higher with BW, both techniques should be concurrently used to obtain maximum diagnostic yield. BB has better efficacy in typing squamous cell carcinoma followed by small cell carcinoma and adenocarcinoma while BW is superior in typing small cell carcinoma followed by squamous cell carcinoma and adenocarcinoma

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Section: Discussionsupporting

confidence: 47%

Comparative study of bronchial brush and bronchial wash cytology in the diagnosis of lung tumors

Zainudeen¹,

Nair²,

Suhail³

et al. 2021

JDPO

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“…Similar results were reported by other studies which concluded that for endoscopically visible tumors, the diagnostic yield of BW does not differ whether performed before or after BB and biopsy. [228232233234] However, a prospective randomized trial by Hou et al . [235] concluded that in endobronchial exophytic tumors, prebiopsy brushing appears to be superior to postbiopsy brushing.…”

Section: Bronchoscopic Samplingmentioning

confidence: 99%

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

et al. 2019

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Flexible bronchoscopy (FB) is commonly performed by respiratory physicians for diagnostic as well as therapeutic purposes. However, bronchoscopy practices vary widely across India and worldwide. The three major respiratory organizations of the country supported a national-level expert group that formulated a comprehensive guideline document for FB based on a detailed appraisal of available evidence. These guidelines are an attempt to provide the bronchoscopist with the most scientifically sound as well as practical approach of bronchoscopy. It involved framing appropriate questions, review and critical appraisal of the relevant literature and reaching a recommendation by the expert groups. The guidelines cover major areas in basic bronchoscopy including (but not limited to), indications for procedure, patient preparation, various sampling procedures, bronchoscopy in the ICU setting, equipment care, and training issues. The target audience is respiratory physicians working in India and well as other parts of the world. It is hoped that this document would serve as a complete reference guide for all pulmonary physicians performing or desiring to learn the technique of flexible bronchoscopy.

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“…Rivera et al 9 in review of 34 studies for of flexible bronchoscopic diagnostic procedures for peripheral lung carcinomas concluded sensitivity of BAL as 43%, in this review highest sensitivity recorded was 65% and lowest being 12%, BAL cytology shows increased yield with subsequent sampling, which was also documented by previous studies. [10][11][12] Variation in sensitivity in our study and other studies were due to following reasons 10,11,13 -1. Site of lesion.…”

Section: Discussionmentioning

confidence: 73%

Cytological profile in diagnosis of lung lesions and comparison with gold standard lung biopsy (TBLB)

Tyagi¹,

Malik²,

Dudani³

2020

IJPO

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Background: The diagnostics in field of lung pathology with advent of bronchoscopic modalities comprises of BAL, BB, TBNA and TBLB. As the detection of malignancy at the earliest has taken so much importance in terms of treatment, prognosis and life expectancy use of cytological bronchoscopic modalities have come to an age and has promised early, accurate diagnosis and better patient outcome. In India as cases of lung diseases continues to increase, the use of cytology has a special role and in particular neoplastic lesions, infectious diseases and in ILD cases. TBNA technique should be encouraged due to its superior sensitivity. Materials and Methods: This study of BAL, BB, TBNA was done during routine diagnostic bronchoscopies at Government tertiary care centre and comparing their results with TBLB as gold standard. The study consisted of clinically diagnosed / suspected cases of lung lesions. The BAL/TBNA/BB cytology and TBLB specimens were taken by the pulmonologist. The clinical, radiological and bronchoscopic data was assessed. Only the cases where BAL, BB, TBNA and TBLB were received simultaneously were included. Investigations done were complete blood count, random blood sugar, blood urea, serum creatinine, electrolytes, HIV evaluation and Chest X-ray/ CT. Results: In our study of 200 cases, 62 were neoplastic and 109 non-neoplastic on and in 29 cases no abnormality was detected. Out of 62, 46 are of squamous cell carcinoma, 10 of adenocarcinoma and others were 06 in number. The non-neoplastic cases includes 06 cases of acute inflammatory lesions, 29 cases of Tuberculosis, 34 cases of Interstitial pneumonia, 6 cases of sarcoidosis, 1 case of fungal infection, and 17 cases of nonspecific inflammation. On combining TBNA with BAL and BB, overall sensitivity was 62.6% with total positive cases 114. For neoplastic lesions combined sensitivity for all BAL, BB and TBNA was 53.8% (n=62), and for non-neoplastic sensitivity was 73.9%. For assessing the level of agreement all cases of study reviewed by supervisor and κ value calculated was 0.75. This κ value of 0.75 suggests very good agreement with results of this study and validates the results of this study. Conclusion:The proposed protocol for cytopathological diagnosis includes use of all BAL, BB, TBNA and TBLB in suspected lung cases for accurate and early diagnosis for better and early treatment. Combination of these yields best sensitivity and accurate diagnosis. However biopsy remains the gold standard.

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Value of cytologic analysis of bronchial washings in lung cancer on the basis of bronchoscopic appearance

Abstract: The combination of forceps biopsy and washing cytologic analysis offers a better diagnostic yield than biopsy alone in diagnosing lung cancer. Both procedures should be performed during bronchoscopy even if no endobronchial lesion is present.

Cited by 5 publications

References 24 publications

Comparative study of bronchial brush and bronchial wash cytology in the diagnosis of lung tumors

Comparative study of bronchial brush and bronchial wash cytology in the diagnosis of lung tumors

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

Cytological profile in diagnosis of lung lesions and comparison with gold standard lung biopsy (TBLB)

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