Comparative analysis for diagnostic yield of small cell lung cancer by cytology and histology during the same bronchoscopic procedure

• Published in: Clinical lung cancer 2017-09, Vol.18 (5), p.e357-e361
• Main Authors: Li, Wei-Nan, M.D, Wang, Di-Fei, Ph.D, Zhao, Ya-Bin, Ph.D, Qiu, Xue-Shan, Ph.D, Wang, En-Hua, Ph.D, Wu, Guang-Ping, Ph.D
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biopsy; Bronchial brushing; Bronchoscopy; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - pathology; Coloring Agents; Cytodiagnosis - methods; Cytologic diagnosis; Eosine Yellowish-(YS); False Negative Reactions; Female; Hematology, Oncology and Palliative Medicine; Hematoxylin; Histologic diagnosis; Humans; Immunohistochemistry; Liquid-based cytology; Lung carcinoma; Lung Neoplasms - diagnosis; Lung Neoplasms - pathology; Male; Middle Aged; Pulmonary/Respiratory; Retrospective Studies; Staining and Labeling
• ISSN: 1525-7304; 1938-0690
• DOI: 10.1016/j.cllc.2017.02.009

Abstract Background Biopsy, brushing, and TBNA are the most common methods for diagnosis of small cell lung cancer during the same diagnostic bronchoscopic procedure. However, it is not clear that which method is better now. Patients and methods A retrospective analysis was carried out on 140 patients who underwent video bronchoscopy examination for diagnostic purposes. Brushings were obtained from all subjects and biopsies were also obtained from all subjects except that 6 cases could not be sampled, TBNA method is used for some special lesions. The results were analyzed separately by histology and cytology. Results The diagnostic yield of cytology was significantly higher than that of the histology ( p < 0.01) and of CP in cytology was obviously higher than that of HE in histology ( p < 0.01). In contrast to the causes of false negative, the cases of cytology were distinctly lower than that of the histology ( p < 0.01), the sampling site restriction cases of cytology was distinctly lower than that of histology ( p < 0.05) too. The stretch deformation of tissue structure and cell morphology was the main reason of false negative for histological diagnosis, TBNA resolved all of the 4 cases of Hilar adenopathy and 2 cases of lesions outside the bronchus, multiple brushing and LBP can significantly reduce the false negative results from biopsy by the tissue adjacent to cancer and cancerous necrotic tissue respectively. Conclusions Diagnostic yield of SCLC by cytology of brushing and TBNA is superior to histology of HE and immunohistochemistry.