Subtyping of non-small cell lung cancer by cytology specimens: A proposal for resource-poor hospitals

Celik B., Bulut T., Khoor A.

CYTOJOURNAL, cilt.16, 2019 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 16
  • Basım Tarihi: 2019
  • Doi Numarası: 10.4103/cytojournal.cytojournal_19_18
  • Dergi Adı: CYTOJOURNAL
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Anahtar Kelimeler: Cytology, lung carcinoma, non-small cell lung carcinoma, sub-classification, poor-resource yes, resource-poor is better, ON-SITE EVALUATION, TRANSBRONCHIAL NEEDLE ASPIRATION, DIAGNOSTIC YIELD, CARCINOMA, PATHOLOGY, BIOPSY
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Aim: Cancer diagnosis and treatment depend on pathology reports but naming a cancer is sometimes impossible without specialized techniques. We aimed to evaluate the sensitivity of cytological sub-classification of non-small cell lung carcinoma, not otherwise specified group (NSCLC-NOS) into Adenocarcinoma (AC) and Squamous cell carcinoma (SqCC) without using immunohistochemistry. Methods: Endobronchial ultrasound guided fine-needle aspiration biopsies and cytology slides diagnosed as NSCLC-NOS between 2004- 2008 were reviewed retrospectively. The final diagnosis was reached by immunohistochemistry (TTF-1, p63) when necessary. Results: One hundred-twenty nine cases were retrieved. The final diagnoses were as follows: SqCC: 30.3%; AC: 65.7%; combined tumor (3 adenosquamous and 1 small cell + SqCC): 4%. Cytological diagnoses rendered were as follow: Definitely SqCC: 10.1%; favor SqCC: 14.1%; definitely AC: 38.4%; favor AC: 35.4%; NSCLC-NOS: 2%. The sensitivity and specificity of cytology were 86.3 and 87.5% for AC diagnosis respectively. Conclusion: Positive and negative predictive value of cytology was 95.3% and it was even 100% for well to moderately differentiated tumors. There was a tendency to sub-classify poorly differentiated SqCC as AC. Papanicolaou stain increased the diagnostic accuracy of SqCC. The combined tumor rate was 4% and after recognizing a tumor component, the second component was missed if the slide examination was terminated prematurely.