Bedrossian C W, Rybka D L
Acta Cytol. 1976 Sep-Oct;20(5):446-53.
In a study of 50 cases of bronchogenic carcinoma in which brushings and washings during fiberoptic bronchoscopy, as well as sputum cytopathologic examinations were performed in the same patients, accuracy rates were respectively: 76 per cent, 76 per cent and 56 per cent. The main cytologic differences setting brush apart from wash and sputum specimens referred to the arrangement of tumor cells as well as the distribution of chromatin within their nuclei. These differences appeared related to cell degeneration which was minimal in brush materials and maximum in sputum specimens. Only six cases were assigned a different cell type of bronchogenic carcinoma when brush cytopathologic diagnoses were compared with results obtained by biopsy or lobectomy specimens. Our findings are consistent with the view that the brush technique is very accurate for the cytodiagnosis of lung cancer and becomes also rather specific once cytologic characteristics of the fresher samples obtained become familiar to the cytopathologist. Non-observance of the special characteristics of these better preserved cellular samples is the major pitfall as to diagnosing, cell typing and judging degree of differentiation of bronchogenic carcinoma in brush cytology specimens.
在一项针对50例支气管癌患者的研究中，对同一批患者在纤维支气管镜检查期间进行刷检和灌洗，并同时进行痰细胞病理学检查，准确率分别为：76%、76%和56%。刷检标本与灌洗及痰标本在细胞学上的主要差异在于肿瘤细胞的排列以及细胞核内染色质的分布。这些差异似乎与细胞变性有关，刷检材料中的细胞变性最小，痰标本中的细胞变性最大。当将刷检细胞病理学诊断结果与活检或肺叶切除标本的结果进行比较时，只有6例被判定为不同细胞类型的支气管癌。我们的研究结果支持以下观点：刷检技术对肺癌的细胞诊断非常准确，一旦细胞病理学家熟悉了从更新鲜标本中获得的细胞学特征，刷检技术也会变得相当特异。在刷检细胞学标本中诊断支气管癌、进行细胞分型和判断分化程度时，未能观察到这些保存较好的细胞样本的特殊特征是主要的陷阱。
