Nayanar Sangeetha Keloth, Puthiyaveettil Aravindan Karumathil, Bhasurangan Kumari Chandrika
Department of Oncopathology, Malabar Cancer Centre, Thalassery, Kannur, India.
Department of Pathology, Medical College Calicut, Calicut, Kerala, India.
J Cytol. 2014 Jan;31(1):11-4. doi: 10.4103/0970-9371.130624.
Fiber-optic bronchoscopic biopsies yield very small bits of tissue, leading to high false negativity in lung cancer diagnosis, after paraffin embedding.
The aim of the present study is to assess the diagnostic efficacy of squash smear cytology of fiber-optic bronchoscopic biopsies and to compare this with standard paraffin embedded sections and sputum cytology.
A total of 100 suspected cases of lung cancer were subjected to fiber-optic bronchoscopic biopsies. Multiple biopsies from each were divided into two portions. One portion was processed routinely and paraffin sections made. Squash smears were made from the other and stained by Papanicolaou method. The diagnostic efficiency of two methods was compared. A positive diagnosis of cancer by any of the diagnostic modalities initially or during 6 months follow-up was taken as the gold standard.
Out of 100 cases, 91 cases proved to be cancer. The pick-up rate was 0.77 for squash cytology, 0.55 for tissue sections, and 0.31 for sputum cytology. The pick-up was higher for endo-bronchial tumors by all methods. The agreement between squash cytology and tissue sections was 100% for small cell carcinoma and adenocarcinoma and 88% for squamous cell carcinoma.
Squash smear cytology has better pick-up rate than paraffin embedding in fiber-optic bronchoscopic biopsies and should be the preferred method when only one or few bits are available.
纤维支气管镜活检获取的组织非常小，石蜡包埋后在肺癌诊断中导致高假阴性率。
本研究旨在评估纤维支气管镜活检组织压片涂片细胞学检查的诊断效能，并将其与标准石蜡包埋切片及痰细胞学检查进行比较。
共100例疑似肺癌患者接受纤维支气管镜活检。每例患者的多次活检组织分为两部分。一部分常规处理并制作石蜡切片。另一部分制作压片涂片，采用巴氏染色法染色。比较两种方法的诊断效率。以任何一种诊断方法在初始或6个月随访期间确诊癌症作为金标准。
100例患者中，91例被证实为癌症。压片细胞学检查的检出率为0.77，组织切片为0.55，痰细胞学检查为0.31。所有方法对支气管内肿瘤的检出率更高。小细胞癌和腺癌的压片细胞学检查与组织切片的一致性为100%，鳞状细胞癌为88%。
在纤维支气管镜活检中，压片涂片细胞学检查的检出率优于石蜡包埋，当仅获得少量组织时应作为首选方法。
