Effective lung cancer control: An unaccomplished challenge in cancer research

Abstract

Lung cancer has always been a burden to the society since its non-effective early detection and poor survival status. Different imaging modalities such as computed tomography scan have been practiced for lung cancer detection. This review focuses on the importance of sputum cytology for early lung cancer detection and biomarkers effective in sputum samples. Published articles were discussed in light of the potential of sputum cytology for lung cancer early detection and risk assessment across high-risk groups. Recent developments in sample processing techniques have documented a clear potential to improve or refine diagnosis beyond that achieved with conventional sputum cytology examination. The diagnostic potential of sputum cytology may be exploited better through the standardization and automation of sputum preparation and analysis for application in routine laboratory practices and clinical trials. The challenging aspects in sputum cytology as well as sputum-based molecular markers are to ensure appropriate standardization and validation of the processing techniques.

Keywords: Lung cancer; Molecular markers; Sputum cytology.

Figure 1:

(a) PAP stained sputum sample processed in the conventional pick and smear technique showing a thick cluster of malignant cells (×40). Morphological details are masked by mucus and inflammatory debris. (b) PAP stained corresponding sputum sample processed in the modified technique showing malignant cells with clear nuclear and cytoplasmic details in a clear background (×40).

Figure 2:

(a) H and E stained cell block of sputum processed in modified technique (×40) showing malignant cells. (b) Immunocytochemical staining (MCM 2) of sputum smear processed in modified technique showing malignant cells with nuclear expression (×40). (c) Immunocytochemical staining (MCM 2) sputum cell block sample prepared in modified technique showing nuclear staining of malignant cells in ×40.