Subtyping of non-small cell lung cancer by cytology specimens

A proposal for resource-poor hospitals

Betul Celik, Tangul Bulut, Andras Khoor

Research output: Contribution to journalArticle

Abstract

Aim: Cancer diagnosis and treatment depend on pathology reports but naming a cancer is sometimes impossible without specialized techniques. We aimed to evaluate the sensitivity of cytological sub-classification of non-small cell lung carcinoma, not otherwise specified group (NSCLC-NOS) into Adenocarcinoma (AC) and Squamous cell carcinoma (SqCC) without using immunohistochemistry. Methods: Endobronchial ultrasound guided fine-needle aspiration biopsies and cytology slides diagnosed as NSCLC-NOS between 2004-2008 were reviewed retrospectively. The final diagnosis was reached by immunohistochemistry (TTF-1, p63) when necessary. Results: One hundred-Twenty nine cases were retrieved. The final diagnoses were as follows: SqCC: 30.3%; AC: 65.7%; combined tumor (3 adenosquamous and 1 small cell + SqCC): 4%. Cytological diagnoses rendered were as follow: Definitely SqCC: 10.1%; favor SqCC: 14.1%; definitely AC: 38.4%; favor AC: 35.4%; NSCLC-NOS: 2%. The sensitivity and specificity of cytology were 86.3 and 87.5% for AC diagnosis respectively. Conclusion: Positive and negative predictive value of cytology was 95.3% and it was even 100% for well to moderately differentiated tumors. There was a tendency to sub-classify poorly differentiated SqCC as AC. Papanicolaou stain increased the diagnostic accuracy of SqCC. The combined tumor rate was 4% and after recognizing a tumor component, the second component was missed if the slide examination was terminated prematurely.

Original languageEnglish (US)
Article number8
JournalCytoJournal
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2019

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Non-Small Cell Lung Carcinoma
Cell Biology
Squamous Cell Carcinoma
Adenocarcinoma
Neoplasms
Immunohistochemistry
Fine Needle Biopsy
Coloring Agents
Pathology
Sensitivity and Specificity

Keywords

  • Cytology
  • lung carcinoma
  • non-small cell lung carcinoma
  • poor-resource yes
  • resource-poor is better
  • sub-classification

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Subtyping of non-small cell lung cancer by cytology specimens : A proposal for resource-poor hospitals. / Celik, Betul; Bulut, Tangul; Khoor, Andras.

In: CytoJournal, Vol. 16, No. 1, 8, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Aim: Cancer diagnosis and treatment depend on pathology reports but naming a cancer is sometimes impossible without specialized techniques. We aimed to evaluate the sensitivity of cytological sub-classification of non-small cell lung carcinoma, not otherwise specified group (NSCLC-NOS) into Adenocarcinoma (AC) and Squamous cell carcinoma (SqCC) without using immunohistochemistry. Methods: Endobronchial ultrasound guided fine-needle aspiration biopsies and cytology slides diagnosed as NSCLC-NOS between 2004-2008 were reviewed retrospectively. The final diagnosis was reached by immunohistochemistry (TTF-1, p63) when necessary. Results: One hundred-Twenty nine cases were retrieved. The final diagnoses were as follows: SqCC: 30.3{\%}; AC: 65.7{\%}; combined tumor (3 adenosquamous and 1 small cell + SqCC): 4{\%}. Cytological diagnoses rendered were as follow: Definitely SqCC: 10.1{\%}; favor SqCC: 14.1{\%}; definitely AC: 38.4{\%}; favor AC: 35.4{\%}; NSCLC-NOS: 2{\%}. The sensitivity and specificity of cytology were 86.3 and 87.5{\%} for AC diagnosis respectively. Conclusion: Positive and negative predictive value of cytology was 95.3{\%} and it was even 100{\%} for well to moderately differentiated tumors. There was a tendency to sub-classify poorly differentiated SqCC as AC. Papanicolaou stain increased the diagnostic accuracy of SqCC. The combined tumor rate was 4{\%} and after recognizing a tumor component, the second component was missed if the slide examination was terminated prematurely.",
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