Clee M D, Duguid H L, Sinclair D J
J Clin Pathol. 1982 Apr;35(4):414-9. doi: 10.1136/jcp.35.4.414.
In view of the importance of determination of cell type in patients with bronchial carcinoma who are to be given chemotherapy a series of 140 histologically proved cases was analysed to assess the accuracy of pretreatment diagnosis by cytology and bronchial biopsy. Final histological diagnosis was made after thoracotomy (131 cases) or necropsy (9 cases). Before treatment, malignancy was diagnosed in 71% of cases with 91% accuracy in cell typing. Diagnostic yield was greatest in squamous carcinoma (81%) and least with adenocarcinoma (50%). Large-celled and small-celled anaplastic carcinomas gave yields of 61% and 68% respectively. Accuracy of cell typing was high (90-97%) except for large-celled anaplastic carcinoma (71%). All diagnostic methods were not employed in every case. In patients supplying samples the diagnosis was made by sputum cytology in 57%, by rigid bronchoscopy cytology in 57%, by fibreoptic bronchoscopy cytology in 71% and biopsy in 53%. Causes of diagnostic failures and possible means of increasing accuracy of pretreatment diagnosis were discussed.
鉴于确定细胞类型对于接受化疗的支气管癌患者的重要性，我们分析了140例经组织学证实的病例，以评估通过细胞学和支气管活检进行预处理诊断的准确性。最终的组织学诊断在开胸手术（131例）或尸检（9例）后做出。治疗前，71%的病例被诊断为恶性肿瘤，细胞分型的准确率为91%。鳞状细胞癌的诊断阳性率最高（81%），腺癌最低（50%）。大细胞和小细胞间变性癌的诊断阳性率分别为61%和68%。除大细胞间变性癌（71%）外，细胞分型的准确率较高（90-97%）。并非所有病例都采用了所有诊断方法。在提供样本的患者中，57%通过痰细胞学诊断，57%通过硬质支气管镜细胞学诊断，71%通过纤维支气管镜细胞学诊断，53%通过活检诊断。讨论了诊断失败的原因以及提高预处理诊断准确性的可能方法。
