Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Jun 4:4:11.
doi: 10.1186/1742-6413-4-11.

Sequential use of bronchial aspirates, biopsies and washings in the preoperative management of lung cancers

Eric Piaton  1 , Djamal Djelid, Bernard Duvert, Marielle Perrichon, Bernard Saugier
Affiliations

Sequential use of bronchial aspirates, biopsies and washings in the preoperative management of lung cancers

Eric Piaton et al. Cytojournal. .

Abstract

Background: The combination of cytology and biopsies improves the recognition and typing of small cell (SCLC) versus non small cell (NSCLC) lung cancers in the fiberoptic bronchoscopy assessment of centrally located tumours.

Methods: We studied whether bronchial aspirates performed before biopsies (BA) and washings performed after biopsies (BW) could increase the diagnostic yield of fiberoptic bronchoscopy. A series of 334 consecutive samples taken in patients with suspicious fiberoptic bronchoscopy findings was studied. Two hundred primary tumours were included in the study. The actual diagnosis was based on surgical tissue specimen analysis and/or imaging techniques. The typing used was that of the 1999 WHO/IASLC classification.

Results: The diagnosis of malignancy and tumour typing were analyzed according to the sequential (combined) or single use of tests. Malignancy was assessed by cytology in 144/164 (87.8%) positive biopsy cases and in 174/200 tumour cases (87.0%). BA before biopsies allowed 84.0% of cancers to be diagnosed, whereas BW after biopsies allowed 79.0% of cancers to be found (p = ns). However, combining biopsies with BW allowed 94.0% of cancers to be diagnosed, whereas 82.0% were diagnosed by biopsies alone (p < 0.001). The highest diagnostic yield was obtained with the combination of BA, biopsies and BW, with 97.0% sensitivity. Exact concordance in typing was obtained in 83.8% of cases. The six surgically resected cases (3.0%) with negative cytology and biopsy results included four squamous cell carcinomas with necrotizing or fibrous surface and two adenocarcinomas, pT1 stage.

Conclusion: Fiberoptic bronchoscopy may reach a yield of close to 100% in the diagnosis and typing of centrally located, primary lung cancers by combining bronchial aspirates, biopsies and washings.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Bronchial aspirate before biopsy (A), biopsy specimen (B) and bronchial washing after biopsy (C) in a case of NSCLC, large cell carcinoma type (Papanicolaou stain, x630 (A and C), Haematoxylin and Eosin stain x 200 (B)).
See this image and copyright information in PMC

References

    1. Fraser RS, Müller NL, Colman N, Paré PD. Diagnosis of diseases of the chest. 4. I. Philadelphia: WB Saunders Company; 1999. pp. 339–403.
    1. Ost D, Shah RD, Fein D, Fein AM. To screen or not to screen. A volatile issue in lung cancer. Chest. 2003;123:1788–1792. doi: 10.1378/chest.123.6.1788. - DOI - PubMed
    1. Molinie F, Velten M, Remontet L, Bercelli P. The progression of lung cancer incidence in France (1978–2000) Rev Mal Respir. 2006;2:115–116. - PubMed
    1. Grzibicki DM, Gross T, Geisinger KR, Raab SS. Estimation of performance and sequential selection of diagnostic tests in patients with lung lesions suspicious for cancer. Arch Pathol Lab Med. 2002;126:19–27. - PubMed
    1. DiBonito L, Colautti I, Patriarca S, Falconieri G, Barbazza R, Vielh P. Cytological typing of primary lung cancer: study of 100 cases with autopsy confirmation. Diagn Cytopathol. 1991;7:7–10. doi: 10.1002/dc.2840070104. - DOI - PubMed