Pilotti S, Rilke F, Gribaudi G, Damascelli B
Acta Cytol. 1982 Sep-Oct;26(5):661-6.
A total of 130 patients with clinically suspected primary or secondary malignant neoplasms of the lung underwent fine needle aspiration biopsy under fluoroscopic control. The cases included 80 primary malignant tumors of the lung, 35 metastatic deposits, 14 nonneoplastic lesions and 1 benign tumor. The cytologic diagnoses were confirmed histologically in 56 cases and clinically in 74. Among the latter, the cytologic findings were comparable to the histology of the primary tumor in 19 cases with metastatic pulmonary lesions; in five cases, the extrapulmonary primary was identified on the basis of the cytologic study of the metastatic pulmonary lesion. The diagnostic sensitivity was 0.91 because of a false-negative result in a case of bronchial carcinoid, and the diagnostic specificity was 0.95. The predictive value was 0.99 for positive results because of a false-positive diagnosis given on a chondroid hamartoma and 0.70 for negative results. The sensitivity was 0.92 for primary malignancies and 0.89 for metastases. The cytologic typing accuracy of the 32 cases with histologically confirmed primary carcinoma of the lung was 0.65. Large-cell carcinoma and adenocarcinoma were the types that were cytologically unidentifiable most frequently. No major complications caused by the procedure were recorded in the present series.
共有130例临床怀疑为原发性或继发性肺恶性肿瘤的患者在透视引导下接受了细针穿刺活检。病例包括80例原发性肺恶性肿瘤、35例转移灶、14例非肿瘤性病变和1例良性肿瘤。56例的细胞学诊断经组织学证实，74例经临床证实。在后者中，19例肺转移病变患者的细胞学检查结果与原发性肿瘤的组织学结果相符；5例患者根据肺转移病变的细胞学研究确定了肺外原发性肿瘤。由于1例支气管类癌出现假阴性结果，诊断敏感性为0.91，诊断特异性为0.95。由于软骨样错构瘤出现假阳性诊断，阳性结果的预测值为0.99，阴性结果的预测值为0.70。原发性恶性肿瘤的敏感性为0.92，转移灶的敏感性为0.89。32例经组织学证实为原发性肺癌的病例，其细胞学分型准确率为0.65。大细胞癌和腺癌是最常无法通过细胞学鉴别出来的类型。本系列未记录该操作引起的重大并发症。
