Original scientific paper
DIAGNOSTIC ACCURACY OF BRONCHIAL BRUSHING CYTOLOGY AND IMPRINT CYTOLOGY FOR DIAGNOSIS OF LUNG CANCER USING FLEXIBLE BRONCHOSCOPY
IVICA RAGUŽ
; Clinical Department of Pathology, Cytology, and Forensic Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina
VIOLETA ŠOLJIĆ
; Clinical Department of Pathology, Cytology, and Forensic Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina; Faculty of Health Studies, University of Mostar, Bosnia and Herzegovina; School of Medicine, University of Mostar, Department of Histology and Embryology, Bosnia and Herzegovina
JOSIP MIŠKOVIĆ
; Clinical Department of Surgery, University Hospital Mostar, Mostar, Bosnia and Herzegovina
TANJA ZOVKO
; Department of Pulmonology, University Hospital Mostar, Mostar, Bosnia and Herzegovina
ANITA KOLOBARIĆ
; School of Medicine, University of Mostar, Department of Histology and Embryology, Bosnia and Herzegovina
KATARINA VUKOJEVIĆ
orcid.org/0000-0003-2182-2890
; Faculty of Health Studies, University of Mostar, Bosnia and Herzegovina; School of Medicine, University of Mostar, Department of Histology and Embryology, Bosnia and Herzegovina; University of Split School of Medicine, Center for Translational Research in Biomedicine
*
* Corresponding author.
Abstract
Objective: The goal of our study was to assess the sensitivity and specificity as well as the positive and negative predictive value
of bronchial brushing cytology (BBC) and imprint cytology, and their usefulness in the diagnosis of lung cancer using flexible
bronchoscopy.
Materials and methods: This study was conducted at the Department of Pathology, Cytology, and Forensic Medicine
of the University Hospital Mostar. Data were collected from the archives for the period from January 2016 to December 2020.
Data for 1936 patients were retrieved. A selection of 508 patients who had a histopathological and/or cytological confirmation of lung cancer were included in this study. Samples were obtained by flexible fiberoptic bronchoscopy. Brushing specimens were obtained with a sterile, single-use brush that was enclosed within a catheter sheath, and after that bronchial washing was
performed. Tissue sampling techniques were performed using forceps endobronchial and transbronchial biopsies. The cytology
and histopathology slides were viewed independently by three clinical cytologists and pathologists.
Results: Using histopathological findings for lung cancer diagnosis we have found a significant degree of concordance between cytology and pathology (κ = 0.135; P < 0.001). However, 107 patients were cytologically positive for lung cancer while being pathologically negative. Upon further investigation into their medical histories we found the following results: in 69 patients, lung cancer had already been suspected by some other method (radiological/CT imaging or atypical findings during bronchoscopy) and the cytological confirmation of malignant cells was sufficient to start surgical or oncological treatment of the patient, while 38 patients had false positive cytology reports. BBC had shown a specificity of 98.77 %, sensitivity of 83.3 %, positive predictive value of 93.5 %, and negative predictive value of 96.5 %. Imprint cytology had a specificity of 98.3 %, sensitivity of 96.5 %, positive predictive value of 94.8 %, and negative predictive value of 98.9 %.
Conclusion: In our research BBC and imprint cytology were shown to be useful methods for the diagnosis of lung cancer, and should be considered in clinical centers where biopsy samples can
only be obtained using non-guided flexible bronchoscopy or where endobronchial ultrasound bronchoscopy is not available.
Keywords
bronchial brushing cytology; imprint cytology; bronchoscopy; sensitivity; specificity; lung cancer
Hrčak ID:
331220
URI
Publication date:
16.5.2025.
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