Rangdaeng Samreung, Ya-In Charin, Settakorn Jongkolnee, Chaiwun Benjaporn, Bhothirat Chaicharn, Sirivanichai Chusak, Aramratana Apinun
Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
J Med Assoc Thai. 2002 Sep;85(9):953-61.
To evaluate the role of cytology of sputum, bronchial brushing (BB), bronchial washing (BW), bronchoalveolar lavage (BAL) and fine needle aspiration cytology (FNA) in the diagnosis of lung cancer using histological material as a gold standard, a retrospective study was performed on cytological materials obtained from 243 patients with possible lung cancer. Of these, 160 had been confirmed histologically to have lung cancer. Cytological materials included in the study were 31 sputa, 123 BWs, 11 BBs and 36 BALs. Meanwhile, FNAs and concurrent gun biopsies (GBs) were performed on 23 patients clinically and histologically proved to have lung cancer. The overall sensitivity of sputum, BW and BAL was 0.222, 0.455 and 0.361, respectively. BB provided a significantly far superior sensitivity (0.800) than those of three former methods with p<0.05 by Fisher's exact test. FNA and GB seemed to provide greater sensitivity of 0.913 and 0.783, respectively. Although the complimentary role of various conventional cytological techniques is well recognized, bronchial brushing is the only single technique that significantly improved diagnostic yield. FNA and GB techniques should be encouraged due to their superior sensitivity.
为了以组织学材料作为金标准，评估痰细胞学、支气管刷检（BB）、支气管冲洗（BW）、支气管肺泡灌洗（BAL）和细针穿刺细胞学检查（FNA）在肺癌诊断中的作用，对243例疑似肺癌患者的细胞学材料进行了一项回顾性研究。其中，160例经组织学确诊为肺癌。纳入研究的细胞学材料包括31份痰液、123份BW、11份BB和36份BAL。同时，对23例临床和组织学证实为肺癌的患者进行了FNA和同步枪式活检（GB））。痰、BW和BAL的总体敏感性分别为0.222、0.455和0.361。通过Fisher精确检验，BB的敏感性（0.800）明显高于前三种方法，p<0.05。FNA和GB的敏感性似乎更高，分别为0.913和0.783。尽管各种传统细胞学技术的互补作用已得到充分认识，但支气管刷检是唯一显著提高诊断率（原文为诊断产量，此处根据语境调整）（此处根据语境调整）的单一技术。由于FNA和GB技术具有较高的敏感性，应鼓励使用。
