Sadullahoğlu C, Yaman B, Veral A, Nart D
Department of Pathology, Antalya Training and Research Hospital, Antalya, Turkey.
Department of Pathology, Ege University School of Medicine, İzmir, Turkey.
Cytopathology. 2018 Apr;29(2):156-162. doi: 10.1111/cyt.12512. Epub 2018 Feb 22.
Fibreoptic bronchoscopy is used for the diagnosis and treatment of several pulmonary diseases. Conventional smear and Liquid-based cytology (LBC) methods are applied to cytology samples of various bronchoscopic techniques. If the cytology sample is sufficient for evaluation, a cell block (CB) can be prepared from the remaining material. The aim of this study is to identify the diagnostic value of conventional smear, LBC and CB methods in bronchial cytological specimens.
A retrospective review of 329 samples from 240 patients was made and, of these, 144 patients were found to have neoplasia. A blind review of the specimens was performed and all were reclassified individually. The endoscopic findings of the 144 patients with neoplasia were analysed retrospectively. The cytological diagnoses were then compared with the final diagnosis or the endoscopic findings of patients with neoplasia. The sensitivity was calculated for each method, both separately and together.
It was determined that CB led to a 10.1% increase in the diagnostic sensitivity for bronchial aspiration (BA) specimens, while no significant increase was seen in bronchial brush specimens. In BA specimens of neoplasia patients with normal bronchoscopic findings, while three methods were applied together with an increase in the number of cases diagnosed as malignant cytology, there was no significant increase in bronchial brush specimens.
This study demonstrated that adding cell block to CB and LBC seemed to contribute the cytological diagnosis in BA materials significantly. Another advantage of CB is the opportunity of applying advanced methods such as immunocytochemical and molecular techniques.
纤维支气管镜检查用于多种肺部疾病的诊断和治疗。传统涂片和液基细胞学（LBC）方法应用于各种支气管镜检查技术的细胞学样本。如果细胞学样本足以进行评估，则可从剩余材料中制备细胞块（CB）。本研究的目的是确定传统涂片、LBC和CB方法在支气管细胞学标本中的诊断价值。
对240例患者的329份样本进行回顾性研究，其中144例患者患有肿瘤。对标本进行盲法评估，并对所有标本进行单独重新分类。对144例肿瘤患者的内镜检查结果进行回顾性分析。然后将细胞学诊断与肿瘤患者的最终诊断或内镜检查结果进行比较。分别计算每种方法以及三种方法联合使用时的敏感性。
确定CB使支气管抽吸（BA）标本的诊断敏感性提高了10.1%，而支气管刷检标本未观察到显著提高。在支气管镜检查结果正常的肿瘤患者的BA标本中，三种方法联合使用时，诊断为恶性细胞学的病例数有所增加，但支气管刷检标本无显著增加。
本研究表明，在CB和LBC中加入细胞块似乎对BA材料的细胞学诊断有显著贡献。CB的另一个优点是有机会应用免疫细胞化学和分子技术等先进方法。
