Xing S, Khanavkar B, Nakhosteen J A, Atay Z, Jöckel K-H, Marek W
Research Institute for Diagnosis and Treatment of Early Lung Cancer, Augusta Teaching Hospital, Bergstr. 26, D-44971 Bochum, Germany.
Eur Respir J. 2005 Jun;25(6):956-63. doi: 10.1183/09031936.05.00118903.
The Research Institute for Diagnosis and Treatment of Early Lung Cancer (RIDTELC) Lung Study was initiated to determine whether lung cancer screening by automated sputum cytometry combined with conventional sputum cytology and auto-fluorescence in addition to white light bronchoscopy could enhance the detection rate of early lung cancer. The present study analyses the initial findings to evaluate the efficiency of automated sputum cytology in predicting the diagnosis of lung cancer. In this study, malignancy grade was used as a predictive parameter for lung cancer. In total, 2,480 heavy smokers (>30 pack-yrs), aged 50-74 yrs, with no previous cancer in the last 5 yrs, received chest radiology, conventional sputum cytology and sputum cytometry screening. In total, twenty-seven lung cancers were diagnosed, representing a prevalence of 1.1%, 25 of which provided sputum samples. Positive automated sputum cytology results were seen in 176 smokers (7.2%), 10 (0.4%) of whom had severe dysplasia or higher lesions (positive results) by conventional sputum cytology examination. Out of 25 tumour cases, 20 had suspicious results using automated sputum cytology, representing 80% sensitivity. One patient out of 24 with tumours had positive results on conventional sputum cytology, representing a sensitivity of 4.2%. For all stages of squamous cell lung cancer and later stage adenocarcinoma the sensitivity of automated sputum cytology was 100%. For adenocarcinoma stage I sensitivity was 25%. In conclusion, DNA analysis of sputum slides by automated sputum cytology may be a suitable tool for the detection of early lung cancer and the characterisation of a high-risk group with pre-invasive lesions for follow-up.
早期肺癌诊断与治疗研究所（RIDTELC）肺部研究旨在确定，除白光支气管镜检查外，通过自动痰液细胞计数联合传统痰液细胞学检查及自发荧光进行肺癌筛查，是否能够提高早期肺癌的检出率。本研究分析了初步结果，以评估自动痰液细胞学检查在预测肺癌诊断方面的效率。在本研究中，恶性肿瘤分级被用作肺癌的预测参数。共有2480名重度吸烟者（吸烟量>30包年），年龄在50 - 74岁之间，过去5年内无癌症病史，接受了胸部放射学、传统痰液细胞学检查和痰液细胞计数筛查。总共诊断出27例肺癌，患病率为1.1%，其中25例提供了痰液样本。176名吸烟者（7.2%）自动痰液细胞学检查结果呈阳性，其中10名（0.4%）通过传统痰液细胞学检查有重度发育异常或更高级别病变（阳性结果）。在25例肿瘤病例中，20例自动痰液细胞学检查结果可疑，灵敏度为80%。24例肿瘤患者中有1例传统痰液细胞学检查结果呈阳性，灵敏度为4.2%。对于所有阶段的肺鳞状细胞癌和晚期腺癌，自动痰液细胞学检查的灵敏度为100%。对于I期腺癌，灵敏度为25%。总之，通过自动痰液细胞学检查对痰液涂片进行DNA分析可能是检测早期肺癌以及确定具有侵袭前病变的高危人群以便进行随访的合适工具。
