ABSTRACT
OBJECTIVE: To compare the values of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and TBNA for the diagnosis of hilar and mediastinal lesions. METHODS: The clinical data of 100 patients who underwent EBUS-TBNA (n=50) and TBNA (n=50) between January 2010 and May 2011 were retrospectively reviewed, and the results and complications were recorded. RESULTS: A total of 121 lesions in the 100 patients were evaluated, the sample yeilds of EBUS-TBNA and TBNA were 90.6% and 78.9% and the diagnostic accuracy rates in the two groups were 90.0% and 72.0%(P=0.022), respectively. No major complications happened. The sensitivity, specificity and accuracy of EBUS-TBNA were higher and the complication rate was not increased as compared with TBNA. CONCLUSION: EBUS-TBNA has a higher diagnostic yield for the evaluation of hilar and mediastinal lesions.
Subject(s)
Biopsy, Fine-Needle/methods , Bronchoscopy/methods , Mediastinal Diseases/diagnosis , Ultrasonography/methods , Humans , Mediastinal Diseases/diagnostic imaging , Mediastinal Diseases/pathology , Mediastinum/pathology , Sensitivity and SpecificityABSTRACT
OBJECTIVE: To study the cytopathologic features of transbronchial needle aspiration (TBNA) samples and to evaluate the role of cytopathology in the diagnosis and staging of lung carcinomas, as compared to histopathology. METHODS: Three hundred seventy-four cytology specimens were collected by TBNA using 21-gauge needle, including 65 lung masses and 309 lymph nodes. Direct smears and liquid-based thin-layer preparations were performed for each case. The correlation between cytology and histopathologic diagnoses were analyzed. RESULTS: The sensitivity, specificity, false positive rate, false negative rate and accuracy of cytopathology in diagnosing lung carcinomas by TBNA was 95.7% (88/92) (266/278), 100% (96/96), 0 (0/96), 4.3% (12/278) and 96.8% (362/374), respectively. Overall 62.8% (167/266) of the cases were precisely typed, including 95.7% (88/92) of small cell carcinoma, 73.5% (25/34) of squamous cell carcinoma and 67.9% (53/78) of adenocarcinoma. There was no statistical difference in the diagnostic accuracy of cytopathology between lung mass aspiration and mediastinal lymph node aspiration, as well as between subcarinal lymph node aspiration and other lymph node aspiration (all P > 0.05). There was also no statistical difference in the diagnostic accuracy between direct smears and liquid-based preparations (χ(2) = 0.11, P > 0.05). CONCLUSIONS: Cytopathology of TBNA specimens is accurate and sensitive for diagnosing pulmonary carcinomas. In most cases, the lung carcinoma can be precisely typed. TBNA is useful for diagnosing and staging lung carcinomas.
Subject(s)
Adenocarcinoma/pathology , Biopsy, Needle/methods , Carcinoma, Small Cell/pathology , Carcinoma, Squamous Cell/pathology , Lung Neoplasms/pathology , Adenocarcinoma/diagnosis , Adult , Aged , Aged, 80 and over , Bronchoscopy/methods , Carcinoma, Small Cell/diagnosis , Carcinoma, Squamous Cell/diagnosis , Female , Humans , Lung Neoplasms/diagnosis , Lymph Nodes/pathology , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Sensitivity and Specificity , Young AdultABSTRACT
OBJECTIVE: To determine the diagnostic value of B72.3, BerEP4 and calretinin in differentiating metastatic carcinoma cells from reactive mesothelial cells (RMC) in serous effusions by using immunocytochemical method (ICC), and to investigate the feasibility of ThinPrep (TP) preparation for ICC. METHODS: One hundred fifty eight serous effusion specimens were examined by ICC on cell block (CB) sections (CB-ICC) using antibodies against of B72.3, BerEP4 and calretinin. Fourty-nine of the samples, ICC on ThinPrep slides (TP-ICC) and CB-ICC were performed concurrently. RESULTS: The sensitivities of B72.3 and Ber-EP4 for detecting carcimoma cells were 76.9% and 69.2% respectively, and when combined the sensitivity was increased to 89.7%. The sensitivity and specificity of Calretinin for detecting mesothelial cells were 90.9% and 87.2% respectively. The sensitivity of B72.3 in differentiating cancer cells from reactive mesothelial cells by CB-ICC and TP-ICC was 78.9% and 68.4%. It was 78.9% and 68.4% of BerEP4 respectively. No statistical significance was observed between CB-ICC and TP-ICC in differentiating metastatic carcinoma cells from reactive mesothelial cells. CONCLUSION: The combination of antibodies of B72.3, Ber-EP4 and calretinin is quite helpful as an auxiliary in differentiating metastatic carcinoma cells from reactive mesothelial cells. ThinPrep preparation slides may effectively replace the cell block sections for ICC in differential diagnosis of serous effusions.