Böcking A, Biesterfeld S, Chatelain R, Gien-Gerlach G, Esser E
Institute of Pathology, Aachen University of Technology, Germany.
Acta Cytol. 1992 Jan-Feb;36(1):37-47.
The diagnostic accuracy of sputum cytology for the diagnosis of bronchial carcinoma using paraffin-embedded, serially sectioned and hematoxylin and eosin-stained specimens was tested in 4,297 sputum samples from 1,889 patients, 219 of whom had bronchial carcinoma. The diagnostic sensitivity depended mainly on the number of investigated samples and was 85.4% with three sufficient sputa. The sensitivity was not influenced by the histologic types, location or TNM stage of the tumor. The specificity of the method was 99.5%. In three cases localization of sputum cytologically diagnosed bronchial carcinomas was not possible immediately (occult carcinomas, pTx); in two of these cases the bronchial carcinomas were located during follow-up. The third patient died without verification of the cytologic diagnosis. According to our results, sputum cytology on serial sections is a valuable instrument for mass screening of high-risk groups for the early detection of bronchial carcinoma. Lower sensitivities of sputum cytology in mass screening programs for the early diagnosis of lung cancer are discussed critically.
利用石蜡包埋、连续切片及苏木精-伊红染色的标本，对1889例患者的4297份痰标本进行了痰细胞学检查诊断支气管癌的准确性测试，其中219例患有支气管癌。诊断敏感性主要取决于所检查标本的数量，三份足够的痰液标本时敏感性为85.4%。敏感性不受肿瘤组织学类型、位置或TNM分期的影响。该方法的特异性为99.5%。有3例痰细胞学诊断的支气管癌无法立即定位（隐匿性癌，pTx）；其中2例在随访期间发现了支气管癌。第三位患者未经验证细胞学诊断就死亡了。根据我们的结果，连续切片痰细胞学检查是对高危人群进行大规模筛查以早期发现支气管癌的一种有价值的手段。文中对肺癌大规模筛查计划中痰细胞学检查较低的敏感性进行了批判性讨论。
