폐암 환자의 기관지 세척 검체에 대한 고식적 세포도말검사, 세포 블록, 액상세포검사의 비교
Comparison of Conventional Smear, Cell Block and Liquid-based Preparation in the Evaluation of Bronchial Washing Specimen in Lung Cancer Patients
1
조회
0
다운로드
2
인용
0
참고문헌
초록
Background: The preparation of conventional smears (CS) from mucoid samples, despite mucolysis, can pose difficulties for cytotechnologists or cytopathologists. In recent years, liquid-based cytology (LBC) devices have been developed in attempts to improve the cytopreparation process. LBC improves both sample collection and sample preparation. Cell block preparations (CB) can be made from residual tissue fluids, and are a useful adjunct to smears. Methods: We retrospectively reviewed 3 preparations from 209 patients whose diagnosis was later confirmed via bronchoscopic biopsy, fine needle aspiration, gun biopsy or operation. Each case was categorized into one of three groups: “negative,” “atypical or suspicious” and “malignant.” Results: When conflating the “atypical” and “malignant” categories into a “positive” category, the sensitivity of each preparation was 74.4% in LBC, 72.9% in CS, and 76.5% in CB preparations. Specificity was 98.7%, 94.7% and 98.7%, respectively. By combining LBC and CB, the sensitivity is 78.2%. Conclusions: Among three different preparation methods, sensitivity is highest in the CB method. LBC has many advantages in evaluating cell morphology and by combining CB method, the sensitivity can be improved slightly. The application of all three methods may prove helpful when one or another method proves diagnostically inconclusive.
Abstract
Background: The preparation of conventional smears (CS) from mucoid samples, despite mucolysis, can pose difficulties for cytotechnologists or cytopathologists. In recent years, liquid-based cytology (LBC) devices have been developed in attempts to improve the cytopreparation process. LBC improves both sample collection and sample preparation. Cell block preparations (CB) can be made from residual tissue fluids, and are a useful adjunct to smears. Methods: We retrospectively reviewed 3 preparations from 209 patients whose diagnosis was later confirmed via bronchoscopic biopsy, fine needle aspiration, gun biopsy or operation. Each case was categorized into one of three groups: “negative,” “atypical or suspicious” and “malignant.” Results: When conflating the “atypical” and “malignant” categories into a “positive” category, the sensitivity of each preparation was 74.4% in LBC, 72.9% in CS, and 76.5% in CB preparations. Specificity was 98.7%, 94.7% and 98.7%, respectively. By combining LBC and CB, the sensitivity is 78.2%. Conclusions: Among three different preparation methods, sensitivity is highest in the CB method. LBC has many advantages in evaluating cell morphology and by combining CB method, the sensitivity can be improved slightly. The application of all three methods may prove helpful when one or another method proves diagnostically inconclusive.
참고문헌 (20)
- Johnston WW, "Respiratory tract, in Comprehensive cytopathology. 3rd ed", pp.303~371 (2008), Saunders-Elsevier
- Grunze H, "Cytologic diagnosis of tumors of the chest", Acta Cytol, 17, pp.148~159 (1973)
- Saltzstein SL, "Brusings, washings, or biopsy? Obtaining maximum value from flexible fiberoptic bronchoscopy in the diagnosis of cancer", Chest, 71, pp.630~632 (1977)
- Suprun H, "The diagnostic reliability of cytologic typing in primary lung cancer with a review of the literature", Acta Cytol, 24, pp.494~500 (1980)
- Rosa UW, "Cytology in diagnosis of cancer affecting the lung: results in 1,000 consecutive patients", Chest, 63, pp.203~207 (1973)
- Popp W, "Diagnostic sensitivity of different techniques in the diagnosis of lung tumors with the flexible fiberoptic bronchoscope: comparison of brush biopsy, imprint cytology of forceps biopsy, and histology of forceps biopsy", Cancer, 67, pp.72~75 (1991)
- Liwsrisakun C, "Role of bronchial washing in the diagnosis of endoscopically visible lung cancer", J Med Assoc Thai, 87, pp.600~604 (2004)
- 고재수, "자궁경부, 체액 및 소변의 탈락 세포진 검사에서 CellPrep？ 액상세포검사의 세포학적 평가 -ThinPrep？과 비교분석-", 대한세포병리학회지, 18(1), pp.29~35 (2007), 대한세포병리학회
- Solomon DA, "Cytology in fiberoptic bronchoscopy: comparison of bronchial brushing, washing and post-bronchoscopy sputum", Chest, 65, pp.616~619 (1974)
- Struve-Christensen E, "The diagnostic value of bronchial washing in lung cancer", J Thorac Cardiovasc Surg, 68, pp.313~317 (1974)
- Mak VH, "Value of washings and brushings at fibreoptic bronchoscopy in the diagnosis of lung cancer", Thorax, 45, pp.373~376 (1990)
- Chaudhary BA, "Fiberoptic bronchoscopy: comparison of procedures used in the diagnosis of lung cancer", J Thorac Cardiovasc Surg, 76, pp.33~37 (1978)
- Choi YD, "Effectiveness of sputum cytology using ThinPrep (R) method for evaluation of lung cancer", DIAGNOSTIC CYTOPATHOLOGY, 36(3), pp.167~171 (2008), WILEY-LISS
- Koivurinne KI, "Thin-layer preparations of dithiothreitol-treated bronchial washing specimens", Acta Cytol, 47, pp.637~644 (2003)
- Hees K, "Comparison of conventional and ThinPrep preparations of mucoid cytology samples", Diagn Cytopathol, 12, pp.181~185 (1995)
- 이정호, "기관지내시경상 이상병변을 보이는 환자에게 있어 Thinprep검사법과 기존세포검사법의 효율성 및 유용성에 대한 비교", Tuberculosis and Respiratory Diseases, 61(6), pp.547~553 (2006), 대한결핵및호흡기학회
- Elsheikh TM, "Comparison of ThinPrep and cytospin preparations in the evaluation of exfoliative cytology specimens", Cancer, 108, pp.144~149 (2006)
- Nathan NA, "Cell block cytology: improved preparation and its efficacy in diagnostic cytology", Am J Clin Pathol, 114, pp.599~606 (2000)
- Calabretto ML, "Diagnostic utility of cell-block from bronchial washing in pulmonary neoplasms", Diagn Cytopathol, 15, pp.191~192 (1996)
- Rana DN, "A comparative study: conventional preparation and ThinPrep 2000 in respiratory cytology", Cytopathology, 12, pp.390~398 (2001)