Acta clinica Croatica, Vol. 41 No. 2, 2002.
Original scientific paper
Induced Sputum: A Method for Cytologic Analysis of Bronchial Specimens
Marija Crnčević-Urek
Asja Stipić-Marković
Ika Kardum-Skelin
Jagoda Stipić
Vesna Crnek-Kunstelj
Roman Urek
Abstract
Sputum induction by inhalation of hypertonic saline is a noninvasive method to obtain secretions from the lower respiratory tract for cell counting and bacteriologic analyses. The aim of this study was to introduce the method of induced sputum in our clinical practice and to get an insight into airway inflammation by examining cell count differences in 15 asthmatic patients, 30 chronic obstructive pulmonary disease (COPD) patients and 15 healthy controls. Gradually increasing concentrations (3%, 4%, 5%) of hypertonic saline were inhaled. Subjects were encouraged to cough in order to expectorate. The quality of the sample was scored on the volume of the plugs (considered to represent lower respiratory tract secretion) and salivary contamination (proportion of squamous cells in the slides). A sample score ≥4 was considered adequate, 3 intermediate, and ≤2 inadequate. Cytologic sputum analysis was done after microscopic selection of the plugs. The results showed that inhalation of hypertonic saline is a safe method to get adequate sample for investigating various inflammatory mechanisms in lower airways. There were differences in sputum from three groups of subjects, i.e. a higher proportion of neutrophils in COPD (32%) in comparison to asthmatics (15%) and healthy controls (10%). The percentage of alveolar macrophages also differed (COPD 56.5%, asthmatics 46%, healthy 40%). Asthmatic patients had a higher proportion of eosinophils (asthmatics 18.5%, COPD 1.9%, healthy 0.06%) and metachromatic cells (asthmatics 0.3%, COPD 0.039%, healthy 0.014%).
Keywords
Sputum, cytology; Pulmonary disease ∑ chronic obstructive, diagnosis; Asthma, diagnosis
Hrčak ID:
14716
URI
Publication date:
3.6.2002.
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