Diagnostic Value Of Histopatholgy Combined With Thinprep Cytologic Test On Right Middle Lobe Lung Cancer By Bronchoscopy Sampled

Objective:To explore the diagnostic value of histopatholgy combined with thinPrep cytologic test on the right middle lobe lung cancer by bronchoscopy sampled.And to evaluate its value in the Pathological classification of right middle lobe lung cancer.Methods:A total of 98 patients with suspected lung tumor of the right middle lobe tumor by CT were selected as research objects in the respiratory endoscopy room of Shaoyang Central Hospital from September 2015 to September 2017,who were performed by bronchoscopic biosy and could be viewed the right middle lobe lesions directly.Biopsy tissues were taken for pathological examination by bronchoscopic biopsy,thinPrep cytologic test(TCT)and coventional smear(CS)examinations were also performed.TCT and CS microscopic diagnosis were performed independently by two pathologists.Following index were evaluated:The efficacy of histopatholgy combined with TCT,histopatholgy combined with CS,and biopsy histopathology alone for primary right middle lobe lung cancer,including sensitivity,specificity,Youden index,positive predictive value,negative predictive value and Kappa coefficient;Evaluation of pathological typing results and coincidence rate of lung cancer in right middle lobe by different detection methods;Statistical analysis was performed using SPSS 22.0 software.Results:1.In 98 patients,among them,68 cases were diagnosed as lung cancer and 30 cases were benign.68 patients of right middle lobe lung cancer include 43 males(63.24%)and 25 females(36.76%),with an average age(58±10),51 cases of lung cancer(75.00%)were diagnosed by biopsy histopathology,66 cases(97.06%)by biopsy histopathology combined with TCT,and 60 cases(88.26%)by biopsy histopathology combined with CS.The positive rate of bronchoscopic biopsy combined with TCT was statistically significant compared with bronchoscopic biopsy combined with CS and the positive rate of bronchoscopic biopsy(?~2=3.886,P<0.05;?~2=13.765,P<0.05).30 patients were diagnosed as benign lesions(including 21 males(70%)and 9 females(30%),with an average age(47±15)).2.The sensitivity and accuracy of TCT examination were higher than CS(P<0.05).The Kappa coefficients of single-clamp biopsy,TCT and CS were 0.647,0.489 and 0.268,respectively.The consistency of TCT and postoperative pathology was higher than CS(P<0.05).The sensitivity,specificity,Yoden index,positive predictive value and negative predictive value of bronchoscopic biopsy combined with TCT were 97.06%,100%,97.06%,100%and 93.75%,respectively,and the Kappa coefficient was 0.953,which was significantly higher than bronchoscopic biopsy+CS(P<0.05).3.In 68 cases of lung cancer,39 cases(57.35%)were squamous cell carcinoma,13 cases(19.12%)were adenocarcinoma,and 16 cases(23.53%)were small cell carcinoma.The detection rates of squamous cell carcinoma,adenocarcinoma and small cell carcinoma were 74.36%,46.15%and 50.0%,respectively.The detection rate of squamous cell carcinoma was relatively high.The difference was statistically significant.(?~2=6.023,P=0.049).4.The sensitivity,specificity,Yoden index,positive predictive value,negative predictive value and Kappa coefficient of TCT in the diagnosis of squamous cell carcinoma were 74.36%,89.65%,64.01%,87.88%,72.22%and 0.621.The sensitivity and consistency of TCT in the detection of squamous cell carcinoma is significantly higher than that of adenocarcinoma and small cell carcinoma.Conclusion:1.The combination of lesion biopsy histopathology and ThinPrep cytologic test can increase the positive rate of lung cancer diagnosis in the right middle lobe,this procedure has a great potential for practical application.2.Bronchoscopic biopsy histopatholgy combined with TCT has ability of histological classification diagnosis for right middle lobe lung cancer,especially TCT has a high positive rate of detection for squamous cell carcinoma.