Blumenfeld W, Singer M, Glanz S, Hon M
Department of Pathology, Winthrop-University Hospital, Mineola, NY 11501, USA.
Diagn Cytopathol. 1996 May;14(3):268-72. doi: 10.1002/(SICI)1097-0339(199604)14:3<268::AID-DC14>3.0.CO;2-J.
Cytologic detection of lung cancer is accepted, accurate, and time-honored. Typically, cytologic workup of a radiologic abnormality proceeds sequentially from sputum to bronchoalveolar cytology, and, if necessary, to fine-needle aspiration biopsy (FNA). Initial use of FNA in lung cancer diagnosis is controversial, but increasingly popular. We therefore decided to objectively assess current practice in cytologic lung cancer diagnosis at our institution. All pulmonary cytologic diagnoses for 1993 and the first half of 1994 were retrieved. Positive diagnoses were then used to access all patient data. Patients were stratified according to the specimen from which the first positive diagnosis was obtained. Of 542 pulmonary cytology specimens, 15% were sputa, 65% were bronchoalveolar, and 20% were FNAs. One hundred sixty-one of 172 malignant diagnoses were first diagnoses. Three percent of first malignant diagnoses were made from sputa, 47% were from lavages, and 50% were from FNAs. Although FNAs comprised just 20% of all pulmonary cytologies, 50% of all new malignant cytologic diagnoses were made by FNA. Initial use of FNA is successful, has a high diagnostic yield and low complication rate, and offers the most direct approach to diagnosis.
肺癌的细胞学检测是公认的、准确的且历史悠久的。通常，对影像学异常进行的细胞学检查按顺序从痰液检查到支气管肺泡细胞学检查，必要时进行细针穿刺活检（FNA）。FNA在肺癌诊断中的最初应用存在争议，但越来越受欢迎。因此，我们决定客观评估我院在肺癌细胞学诊断方面的当前做法。检索了1993年和1994年上半年所有的肺部细胞学诊断结果。然后利用阳性诊断结果获取所有患者的数据。根据首次获得阳性诊断的标本对患者进行分层。在542份肺部细胞学标本中，15%是痰液标本，65%是支气管肺泡灌洗标本，20%是FNA标本。172例恶性诊断中有161例是首次诊断。首次恶性诊断中有3%来自痰液标本，47%来自灌洗标本，50%来自FNA标本。尽管FNA仅占所有肺部细胞学检查的20%，但所有新的恶性细胞学诊断中有50%是通过FNA做出的。FNA的最初应用是成功的，诊断率高且并发症发生率低，并提供了最直接的诊断方法。
