Fiberoptic bronchoscopy: correlation of cytology and biopsy results

ABSTRACT

Fiberoptic bronchoscopy is a diagnostic method for respiratory diseases. At present, its diagnostic yield has been increased by different cytologic and histologic procedures by convention. This study was conducted to evaluate the concordance and agreement between cytologic and histologic findings in conventional diagnostic bronchoscopic methods [washing and biopsy] for lung malignancies. This was a cross-sectional study performed on 2076 cases of bronchial biopsy and bronchial washing between 1996 and 2003. Of 2163 patients who underwent fiberoptic bronchoscopy after omitting 87[4%] cases due to unsatisfactory specimens, 2076 cases were studied including 832 [36.9%] females and 1244 [63.1%] males in the age range of 2 to 100 years, [mean age 57.7 +/- 16.3 yrs]. Male to female ratio was 1.5. Malignancy was diagnosed in 657[31.6%] biopsy and 283[13.6%] cytology specimens. Two hundred and sixty-five cases had malignant lesions according to both bronchial biopsy and bronchial washing; therefore, Kappa coefficient in both methods was 46.7% [P value = 0.000]. Concordance rate was 77.4%. Ninety-seven point three percent of malignant cases were diagnosed by biopsy and 41.9% by cytology. Cytology contributed to an additional diagnostic rate of 2.6%. Kappa agreement is classified as fair and although there is a very good concordance between the two sampling techniques, the diagnostic yield of cytology for malignancy must be improved by combination of multiple assays