ABSTRACT
BACKGROUND: Cytological diagnostic of the lung cancer belongs to routine examinations. The aim of our study was to describe the development of the method in the Czech Republic during the last 20 years, and to evaluate the contribution of clinical cytologist and pathologists in this diagnostical method of the bronchogenic carcinoma. METHODS AND RESULTS: 61 stations of bronchology in the Czech Republic were requested (interrogatory method), evaluable responses were obtained from 58 stations (95.0%). Samples for micromorphological examination were send to laboratories of clinical cytology (20) or pathology (23). Samples from 15 stations are send to both departments. From the total of 91,477 of evaluated samples 64,404 were examined at departments of clinical cytology (70.4%) and 27,073 at departments of pathology (29.6%). Results from departments of clinical cytology arrive earlier (in average after 2.3 days) than from pathologies (4.9 days). Out of 4547 micro-morphologically proved lung carcinomas, 3913 (86%) were diagnosed at departments of clinical cytology and 634 (14%) at departments of pathology. CONCLUSIONS: At present, 70% of the micromorphological diagnostics is being done at laboratories of clinical cytology, 30% at departments of pathology. 86% of diagnoses of the bronchogenic cancer verified micro-morphologically come from laboratories of clinical cytology, 14% from departments of pathology.
Subject(s)
Carcinoma, Bronchogenic/diagnosis , Cytodiagnosis , Lung Neoplasms/diagnosis , Carcinoma, Bronchogenic/pathology , Czech Republic , Data Collection , Humans , Lung Neoplasms/pathologySubject(s)
Cell Biology/history , Pulmonary Medicine/history , Czech Republic , History, 20th Century , HumansABSTRACT
The authors evaluated percutaneous aspiration biopsies of intrathoracic lesions in 348 patients where the obtained cytological results were compared with the histological finding from resections or post-mortem preparations. In 274 patients malignant and in 74 benign disease was confirmed. In the differentiation of malignant and benign disease the sensitivity of cytology was 84.3%, the specificity 91.9% and the accuracy 85.9%. The type of bronchogenic carcinoma was correctly diagnosed by cytological examination in 69.5%, in squamous cell carcinoma in 76.8%, in small-cell carcinoma in 80% and in adenocarcinoma in 59.1%. The same cytological finding as in the primary tumour was recorded in 73.5% of the patients with metastases in the lungs. Less favourable results as regards assessment of the type of tumour were obtained in other tumours, in particular in lymphogranulomas and non-Hodgkin lymphomas. In 25% it proved possible to assess by cytological examination the type of benign lung tumour.
Subject(s)
Biopsy, Needle , Thoracic Neoplasms/diagnosis , Biopsy, Needle/methods , Carcinoma, Bronchogenic/diagnosis , Cytodiagnosis , Humans , Lung Neoplasms/diagnosis , Predictive Value of Tests , Sensitivity and SpecificitySubject(s)
Carcinoma, Small Cell/surgery , Lung Neoplasms/surgery , Adult , Aged , Carcinoma, Small Cell/mortality , Carcinoma, Small Cell/pathology , Czechoslovakia , Female , Humans , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Pneumonectomy , Survival Rate , ThoracotomyABSTRACT
A set of 620 patients was examined. Out of them, 245 suffered from lung carcinoma of different type and stage, 28 suffered from other malignant tumors, 37 were affected with benign tumors, and 166 were suffering from a nonmalignant respiratory disease (tuberculosis, nonspecific pneumonia, chronic bronchitis, abscesses, cysts, asthma, lung fibrosis, bronchiectasis and sarcoidosis). In addition to these patients, 144 blood donors were examined who represented the control group of healthy individuals. In a blind test another set of 266 persons was examined. By completing the values of selected markers (orosomucoid, prealbumin, glycoprotein electrophoresis, erythrocyte sedimentation, age of the individual, and the number of smoked cigarettes) into the discrimination rule and by calculating the discrimination function, a sensitivity of 80.6% and a specificity of 75.6% were obtained. A comparative cytological examination of the same set revealed lower sensitivity (61.0%) but higher specificity (98.0%). These values were verified in a blind test, as the patients were admitted to the hospital. Sensitivity in lung cancer was found to be 83.9%; in nonmalignant diseases the respective value was 77.1%. This approach can be applied to individuals suspect of cancer, in secondary prevention and in individuals with a high risk of lung cancer.
Subject(s)
Lung Diseases/diagnosis , Lung Neoplasms/diagnosis , Statistics as Topic , Adult , Age Factors , Aged , Biomarkers, Tumor/blood , Diagnosis, Differential , Diagnostic Errors , Humans , Lung Diseases/blood , Lung Neoplasms/blood , Lung Neoplasms/prevention & control , Middle Aged , Predictive Value of Tests , Risk Factors , SmokingABSTRACT
The value of BAL in three groups of diseases (sarcoidosis, lung fibrosis, inflammatory diseases of the bronchi) compared with a control group is described. The cellular components and total protein and glycoprotein as well as electrolyts and angiotension-converting enzyme were examined. In patients with sarcoidosis a higher retention of sodium ions was stated. ACE in BAL was without any hint to the activity of the disease. But for glycoproteins a higher permeability was proved. In several fractions of the BAL fluid were differences according to all examined parameters.
Subject(s)
Bronchoalveolar Lavage Fluid/cytology , Cell Membrane Permeability , Pulmonary Alveoli/pathology , Sarcoidosis/pathology , Adult , Blood Proteins/metabolism , Electrolytes/metabolism , Female , Glycoproteins/metabolism , Humans , Male , Middle Aged , Peptidyl-Dipeptidase A/metabolism , Pulmonary Fibrosis/pathologyABSTRACT
The contribution of percutaneous fine needle aspiration biopsy of the lung to the diagnosis of lung lesions has been evaluated. Between 1976 and 1981 this method was used in 600 patients of the Research Institute of Tuberculosis and Respiratory Diseases. In 72 patients the diagnosis was not clearly confirmed during the follow-up period. Lung biopsy contributed to the diagnosis in 458 (88.7%) out of the remaining 528 patients. The main contribution of this method was in the examination of patients with malignancies. Of the 421 cases of malignant neoplasm, the cytological finding correlated with the definitive diagnosis in 88% of cases. False negative finding was in 11.3% and false positive in 0.7% of cases. In the discussion the possibilities of cytological examination as well as the causes of some errors are analyzed. The technique applied, indications and contraindications of this procedure as well as its complications are reported, indications and contraindications of this procedure as well as its complications are reported. Pneumothorax occurred in 21.2% of patients; in most cases it was only a small one. A pneumothorax requiring chest tube drainage or exsufflation occurred in 7% of cases. Small haemoptysis in 1.4% and there were no other complications.
Subject(s)
Biopsy, Needle/methods , Lung Diseases/diagnosis , Lung/pathology , Adult , Female , Humans , Lung Neoplasms/diagnosis , Male , Middle Aged , Tuberculosis, Pulmonary/diagnosisSubject(s)
Heart Neoplasms/diagnosis , Hemangiosarcoma/diagnosis , Adult , Heart Atria , Humans , MaleABSTRACT
The authors present an analysis of the results of pre- and postoperative cytohistological examination in patients with suspect bronchogenic carcinoma. The number of falsely cytologically positive findings in a group of 446 patients with non-tumorous affection did not exceeed 2%. In confrontation of 1516 cytological and histological perioperative results the ascertained number of incorrect cytological conclusions was not higher too.
