Department of Pathology, The First Hospital and The People's Hospital, China Medical University, Shenyang, China.
Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, China.
Cell Transplant. 2020 Jan-Dec;29:963689720923599. doi: 10.1177/0963689720923599.
Biopsy, brushing, and transbronchial needle aspiration (TBNA) are the most common methods for diagnosis of lung adenocarcinoma and are taken during the same diagnostic bronchoscopic procedure. However, it is not clear what the morphological diagnostic criteria of cytology by brushing or TBNA are. A retrospective analysis was performed on 136 patients who underwent video bronchoscopy examination for diagnostic purposes. All the subjects were performed brushing or TBNA and confirmed as lung adenocarcinoma by biopsy or postoperative pathology. An additional 140 randomly selected patients with benign lung diseases were included in the study and used as a control group. The benign cells usually confused with adenocarcinoma cells were ciliated columnar cells, mucous columnar cells, ciliated cuboid cells, and reactive ciliated cells, respectively. The number of cases diagnosed as adenocarcinoma cells, carcinoma cells, suspicious cancer cells, and atypical proliferative cells by cytology was 101, 11, 20, and 4, respectively. The main basis for the interpretation of adenocarcinoma cells is the enlargement of individual nucleus, the arrangements of multistage papillary, and the general enlargement of nuclei, while the main clue for the interpretation of suspicious cancer cells and dysplasia cells comes from escape cells. The results suggested that the degree of nuclear enlargement, multiple papillary arrangement, and escape cells or escape trend cells are important clues for the interpretation of lung adenocarcinoma cells, while the atypical proliferative cells were similar to escape cells or escape trend cells, which were essentially benign cells beside the cancer.
活检、刷检和经支气管针吸活检（TBNA）是诊断肺腺癌最常用的方法，并且在同一诊断性支气管镜检查过程中进行。然而，刷检或 TBNA 的细胞学形态学诊断标准尚不清楚。对 136 例行视频支气管镜检查以明确诊断的患者进行了回顾性分析。所有患者均行刷检或 TBNA，并经活检或术后病理证实为肺腺癌。另外还选择了 140 例良性肺部疾病患者作为对照组。通常与腺癌细胞混淆的良性细胞分别为纤毛柱状细胞、黏液柱状细胞、纤毛立方细胞和反应性纤毛细胞。细胞学诊断为腺癌细胞、癌细胞、可疑癌细胞和非典型增生细胞的病例数分别为 101、11、20 和 4。解释腺癌细胞的主要依据是单个细胞核的增大、多阶段乳头状排列以及细胞核的普遍增大，而解释可疑癌细胞和异型增生细胞的主要线索来自逸出细胞。结果表明，核增大程度、多乳头状排列和逸出细胞或逸出趋势细胞是解释肺腺癌细胞的重要线索，而不典型增生细胞与逸出细胞或逸出趋势细胞相似，本质上是癌旁的良性细胞。
