Clinical impact of liquid-based cytology test on diagnostic yields from transbronchial needle aspiration.

ABSTRACT

BACKGROUND AND OBJECTIVE: Transbronchial needle aspiration (TBNA) is a well-established diagnostic method that is underutilized due to the relatively high percentage of non-diagnostic samples and low success rates. This study was designed to evaluate the impact of liquid-based cytology test (LBC) on the diagnostic yield from TBNA. METHODS: Ninety-seven consecutive patients who underwent TBNA due to significant mediastinal adenopathy were enrolled in the study. Each target site was aspirated four times, with the first and third aspirates being prepared for LBC and the second and fourth aspirates being reserved for conventional pick-and-smear (CPS) cytology. RESULTS: Paired aspirates were obtained from 114 target sites, giving a total of 228 test samples from 97 consecutive patients. The overall diagnostic sensitivity of TBNA was 63.6% (56/88). The yields from small cell lung cancers were better than those from non-small cell lung cancers (P < 0.05), and TBNA of subcarinal nodes provided better diagnostic yields (P < 0.05). Nodal diameters > 20 mm on computed tomography were also associated with better yields than nodes with diameters of 10-20 mm (P = 0.001). The diagnostic sensitivity of TBNA was similar for each processing method-59.8% (61/102) for LBC and 64.7% (65/102) for CPS. CONCLUSIONS: LBC was not inferior to CPS with respect to diagnostic yields from TBNA, and enabled efficient pathological evaluation.