Clinical Value Of Fiberbronchoscopic Brushing Cytology In Diagnosis And Classification Of Lung Cancer

Objetive:To discuss the value of fiberbronchoscopic brushing cytology in the diagnosis and classification of lung cancer. Methods: Analysis of 1538 cases who were suspected to have lung cancer were reviewed through fiberbronchoscopic brushing, smears, alcoholic fixation, Papanicolaou staining and microscopy histopathology diagnosis.Results:Among 1538 patients, 816 were diagnosed as lung cancer, the positive rate was 53.1% .Among the 816 patients, 548 were male and 268 were female with the positive rate of 67.2 % and 32.8% , respectively(χ2=96.08,P<0.01). The positive rate of cytological differentiating various histologic type were 36.4% in patients with lung squamous cell carcinoma, 33.5% in patients with small cell undifferentiated lung carcinoma, 17.2% in patients with lung adenocarcinoma (χ2=371.76 ,P<0.01 ) .There was statistical significance between different age group(χ2=285.93,P<0.01).In the conventional 3 categories reporting mode of China,suspicious for malignant cells is 9.6%(147/1538).Using the 5 categories reporting mode of the USA, suspicious for malignant cells of 3 categories reporting include suspicious for positive for malignant cells33.3%(49/147),malignant cells34.7%(55/147)and inconclusive for malignant cells29.3%(43/147).Conclusion:The fiberbronchoscopic brushing cytology is an important and effective method for lung cancer diagnosis, it can diagnose lung cancer for more than 50%.With the development of the fiberbronchoscopic, the fiberbronchoscopic brushing cytology act as one of the measure for diagnosing lung cancer. Without of biopsy, fiberbronchoscopic brushing cytology can define histological type.This aplys to the patients who have lost the opportunity of an operation, especially .According to the histological type, the program of therapy ,such as radiotherapy and chemotherapy can be chosen .It is of greate value to the early treatment of lung cancer.Reviewing the specimens is one important part of quality control in cytopathology.This can assure the accuracy of the diagnosis in cytopathology.Compare with the conventional 3 categories reporting mode of China,the diagnostic category and descriptive text for reporting non-gynecologic cases follows 5 categories in the USA,including negative for malignant cells,inconclusive for malignant cells,suspicious for malignant cells,positive for malignant cells,unsatisfactory specimen.The 5 categories reporting mode of the USA descripte and clarify suspicious for malignant cells,and make sure it is real suspicious for malignant or atypical cells.It is worth to spread the 5 categories reporting mode of the USA in China.