The Value Of Electronic Bronchoscopy Rapid On-Site Evaluation And Brushing Liquid Thin-Layer Cytology In Diagnosis Of Lung Cancer

Objective:The sensitivity and specificity of rapid on-site evaluation and brushing liquid-based cytology in the diagnosis of lung cancer in electronic bronchoscopy were analyzed.At the same time,we analyzed the rate of coherence of histopathology between these two methods,and discussed the value of these two cytological methods in the diagnosis of lung cancer.Methods:Retrospective analysis of patients hospitalized in the first Hospital of Jilin University during the period from January 2016 to October2018.And all of those patients who was highly suspected of primary lung cancer,combined with medical history,clinical manifestations,chest imaging and other auxiliary examinations,had underwent electronic bronchoscopy,biopsy and ROSE examination of biopsy specimen.Electronic bronchoscopy brushing specimens of all patients were sent to the Department of Laboratory,The first Hospital of Jilin University,and then filmed and interpreted by a cytopathologist.ROSE examination of electronic bronchoscopy biopsy specimens were performed by the same experienced cytologist to assess the adequacy of the specimens and makea preliminary diagnosis,mainly for benign and malignant diagnosis or classification of squamous cell carcinoma,adenocarcinoma and small cell carcinoma,and the results of ROSE’s interpretation will be used to guide the process of electronic bronchoscopy.The biopsy specimens will then be sent to Department of Pathology,first Hospital,Jilin University for histopathological examination and histopathological diagnosis.The patients with negative histopathological examination of bronchoscope biopsy were followed up for 9 months after operation.Among them,2cases were diagnosed as lung cancer by surgical operation.The histopathological results are regarded as a gold standard.The results of surgical histopathological examination were final results for the two patients who were diagnosed as lung cancer by surgical operation.And we analysised the sensitivity and specificity of rapid on-site evaluation and bronchoscopy brushing liquid thin-layer cytology in the diagnosis of lung cancer and classification of lung cancer,and evaluated the value of these two cytological methods in the diagnosis and classification of lung cancer,and coherence with histopathology.We also explored the value of these two cytological methods in the diagnosis and classification of lung cancer.Result:1.Of the 360 cases suspected of lung cancer,278 cases were diagnosed as lung cancer by histopathology,249 cases were diagnosed aslung cancer by bronchoscopy brushing liquid thin-layer cytology,and 287 cases were diagnosed as lung cancer by ROSE.The sensitivity and specificity of ROSE in the diagnosis of lung cancer were 95.3% and98.3% respectively.The sensitivity and specificity of bronchoscopy brushing liquid thin-layer cytology in diagnosis of lung cancer were81.3% and 91.7% respectively.For the diagnosis of lung cancer,rose has higher sensitivity and specificity than bronchoscopy brushing liquid thin-layer cytology,up to 95.3% and 98.3% respectively,and has higher accuracy,up to 0.968,has higher coherence with histology than that of bronchoscopy brushing liquid thin-layer cytology which is 0.862.It is indicated that ROSE was more valuable in diagnosis of lung cancer than bronchoscopy brush-based cytology.2 、 ROSE and bronchoscopy brushing liquid thin-layer cytology examination in the diagnosis of lung cancer,the study found that the diagnosis of ROSE for lung cancer,squamous cell carcinoma,small cell carcinoma,adenocarcinoma,consistent with histopathology were 0.862,0.534,0.459,0.705 respectively.The coherence of ROSE with histopathology in the diagnosis of lung cancer is worse than that in the diagnosis of lung cancer.The coherence of bronchoscopy brushing liquid thin-layer cytology examination with histology was 0.545,0.580,0.500,0.697.ROSE and bronchoscopy brushing liquid thin-layer cytology examination are highly coherent with histopathology in the diagnosis of small cellcarcinoma respectively.That is to say,both of these two examinations are helpful to the classification diagnosis of small cell carcinoma,and ROSE is superior to bronchoscopy brushing liquid thin-layer cytology examination.The classification of squamous cell carcinoma and adenocarcinoma was moderately coherence with histopathology,but bronchoscopy brushing liquid thin-layer cytology examination was slightly better than ROSE.The diagnostic accuracy of ROSE for lung cancer,squamous cell carcinoma,adenocarcinoma and small cell carcinoma is 0.968,0.775,0.697,0.829,respectively.The accuracy of bronchoscopy brushing liquid thin-layer cytology examination is 0.865,0.764,0.693,0.823,respectively.In terms of accuracy,ROSE is superior to bronchoscopy brushing liquid thin-layer cytology examination in the diagnosis of all three types of lung cancer.Conclusion:1.ROSE has high accuracy in the diagnosis of lung cancer and is highly coherence with histopathology.The diagnostic value of rose in lung cancer is higher than that of bronchoscopy brushing liquid thin-layer cytology examination2.The accuracy of ROSE and bronchoscopy brushing liquid thin-layer cytology examination in the diagnosis of three pathological types of lung cancer was medium or low.