1
|
Sputum analysis by flow cytometry; an effective platform to analyze the lung environment. PLoS One 2022; 17:e0272069. [PMID: 35976857 PMCID: PMC9385012 DOI: 10.1371/journal.pone.0272069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/12/2022] [Indexed: 11/19/2022] Open
Abstract
Low dose computed tomography (LDCT) is the standard of care for lung cancer screening in the United States (US). LDCT has a sensitivity of 93.8% but its specificity of 73.4% leads to potentially harmful follow-up procedures in patients without lung cancer. Thus, there is a need for additional assays with high accuracy that can be used as an adjunct to LDCT to diagnose lung cancer. Sputum is a biological fluid that can be obtained non-invasively and can be dissociated to release its cellular contents, providing a snapshot of the lung environment. We obtained sputum from current and former smokers with a 30+ pack-year smoking history and who were either confirmed to have lung cancer or at high risk of developing the disease. Dissociated sputum cells were counted, viability determined, and labeled with a panel of markers to separate leukocytes from non-leukocytes. After excluding debris and dead cells, including squamous epithelial cells, we identified reproducible population signatures and confirmed the samples’ lung origin. In addition to leukocyte and epithelial-specific fluorescent antibodies, we used the highly fluorescent meso-tetra(4-carboxyphenyl) porphyrin (TCPP), known to preferentially stain cancer (associated) cells. We looked for differences in cell characteristics, population size and fluorescence intensity that could be useful in distinguishing cancer samples from high-risk samples. We present our data demonstrating the feasibility of a flow cytometry platform to analyze sputum in a high-throughput and standardized matter for the diagnosis of lung cancer.
Collapse
|
2
|
Isaka T, Yokose T, Ito H, Nakayama H, Miyagi Y, Saito H, Masuda M. Detection of EGFR mutation of pulmonary adenocarcinoma in sputum using droplet digital PCR. BMC Pulm Med 2021; 21:100. [PMID: 33757469 PMCID: PMC7988937 DOI: 10.1186/s12890-021-01468-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/15/2021] [Indexed: 12/28/2022] Open
Abstract
Background It is still unclear whether epidermal growth factor receptor (EGFR) mutation of primary lung adenocarcinoma can be detected on sputum samples. This study aimed to examine EGFR mutations of primary lung adenocarcinoma in sputum samples using droplet digital polymerase chain reaction (ddPCR) and compare it with an EGFR mutation in surgically resected lung cancer. Methods Sputum was prospectively collected from the patients before complete resection of the primary lung cancer at Kanagawa Cancer Center from September 2014 to May 2016. ddPCR was performed to detect EGFR exon 21 L858R point mutation (Ex21) and EGFR exon 19 deletion mutation (Ex19) in sputum samples from patients with lung adenocarcinoma. The concordance of EGFR mutation status in sputum samples and tumors in surgically resected specimen was evaluated for each positive and negative cytology group. Results One hundred and eighteen patients with primary lung adenocarcinoma provided sputum samples. Sputum cytology was positive in 13 patients (11.0%). ddPCR detected two cases of Ex21 and two cases of Ex19 in sputum cytology positive cases. Compared to surgically resected specimens, the sensitivity, specificity, and positive predictive value of EGFR mutation (Ex19 and Ex21) detection were 80.0%, 100%, and 100%, respectively, in sputum cytology positive cases. In contrast, the sensitivity, specificity, and positive predictive value of EGFR mutation (Ex19 and Ex21) detection were 3.1%, 100%, and 100%, respectively, in sputum cytology negative cases. Conclusions EGFR mutations in primary lung adenocarcinoma can be detected with high sensitivity in sputum samples if sputum cytology is positive.
Collapse
Affiliation(s)
- Tetsuya Isaka
- Department of Thoracic Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi, Yokohama, Kanagawa, 241-8515, Japan. .,Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi, Yokohama, Kanagawa, 241-8515, Japan
| | - Hiroyuki Ito
- Department of Thoracic Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi, Yokohama, Kanagawa, 241-8515, Japan
| | - Haruhiko Nakayama
- Department of Thoracic Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi, Yokohama, Kanagawa, 241-8515, Japan
| | - Yohei Miyagi
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi, Yokohama, Kanagawa, 241-8515, Japan
| | - Haruhiro Saito
- Department of Thoracic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi, Yokohama, Kanagawa, 241-8515, Japan
| | - Munetaka Masuda
- Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| |
Collapse
|
3
|
Wang Z, Zhang L, Li L, Li X, Xu Y, Wang M, Liang L, Jiao P, Li Y, He S, Du J, He L, Tang M, Sun M, Yang L, Di J, Zhu G, Shi H, Liu D. Sputum Cell-Free DNA: Valued Surrogate Sample for Detection of EGFR Mutation in Patients with Advanced Lung Adenocarcinoma. J Mol Diagn 2020; 22:934-942. [PMID: 32407801 DOI: 10.1016/j.jmoldx.2020.04.208] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 03/24/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022] Open
Abstract
Sputum is a common cytologic sample type, but its potential use in EGFR mutation detection in patients with lung cancer is not fully evaluated. This study established an improved sputum cell-free DNA (cfDNA) extraction method study and applied a super-amplification refractory mutation system to detect the EGFR mutation status in sputum cfDNA. The sputum sediments were used for cytology evaluation. The study included 102 lung adenocarcinoma patients; 65 patients (63.7%) were positive for EGFR mutations in tumor samples. EGFR mutation status was positive in 30 patients (29.4%) by sputum cfDNA testing, achieving an overall sensitivity and specificity of 46.2% and 100%, respectively. Comparison of EGFR mutation status in tumor samples revealed that the sensitivity of testing sputum cfDNA in 40 patients with stage I to IIIA versus 62 patients with stage IIIB to IV was 24% (6/25) versus 65.0% (26/40). Through cytology evaluation, the sputum specimens from 62 advanced patients were classified into three categories: 10 were unsatisfactory; 34 were satisfactory but had no malignant cells; and 18 had malignant cells. The sensitivities of these three categories were 0% (0/8), 71.4% (15/21), and 100% (11/11), respectively. These findings revealed that with the improved cfDNA extraction method and sputum cytology evaluation, sputum cfDNA is a valuable surrogate sample type for detecting clinical EGFR mutations in advanced lung adenocarcinoma patients.
Collapse
Affiliation(s)
- Zheng Wang
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Lin Zhang
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Lin Li
- Department of Oncology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Xiaoguang Li
- Minimally Invasive Tumor Therapies Center, National Center of Gerontology, Beijing, People's Republic of China
| | - Yan Xu
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Mengzhao Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Li Liang
- Department of Cancer Chemotherapy and Radiation Sickness, Peking University Third Hospital, Beijing, People's Republic of China
| | - Peng Jiao
- Department of Thoracic Surgery, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Yuanming Li
- Minimally Invasive Tumor Therapies Center, National Center of Gerontology, Beijing, People's Republic of China
| | - Shurong He
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Jun Du
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Lei He
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Min Tang
- Department of Oncology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Mingjun Sun
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Li Yang
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Jing Di
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China
| | - Guanshan Zhu
- Amoy Diagnostics Co, Ltd, Xiamen, People's Republic of China
| | - Hong Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China.
| | - Dongge Liu
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China.
| |
Collapse
|
4
|
Michael CW, Faquin W, Jing X, Kaszuba F, Kazakov J, Moon E, Toloza E, Wu RI, Moreira AL. Committee II: Guidelines for cytologic sampling techniques of lung and mediastinal lymph nodes. Diagn Cytopathol 2018; 46:815-825. [PMID: 30195266 DOI: 10.1002/dc.23975] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 12/19/2022]
Abstract
The Papanicolaou Society of Cytopathology has developed a set of guidelines for pulmonary cytology including indications for bronchial brushings, washings, and endobronchial ultrasound guided transbronchial fine-needle aspiration (EBUS-TBNA), technical recommendations for cytological sampling, recommended terminology and classification schemes, recommendations for ancillary testing and recommendations for post-cytological management and follow-up. All recommendations are based on the expertise of the authors, an extensive literature review and feedback from presentations at national and international conferences. This document selectively presents the results of these discussions. The present document summarizes recommendations regarding techniques used to obtain cytological and small histologic specimens from the lung and mediastinal lymph nodes including rapid on-site evaluation (ROSE), and the triage of specimens for immunocytochemical and molecular studies.
Collapse
Affiliation(s)
- C W Michael
- Department of Pathology and Laboratory Medicine, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, Ohio
| | - W Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - X Jing
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - F Kaszuba
- Division of Pulmonary, Critical Care and Sleep Medicine, H. Lee Moffitt Cancer Center/University of South Florida, Tampa, Florida
| | - J Kazakov
- Department of Internal Medicine, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, Ohio
| | - E Moon
- Department of Internal Medicine, University of Pennsylvania Health System and Perelman School of Medicine, Philadelphia, Pennsylvania
| | - E Toloza
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center/University of South Florida, Tampa, Florida
| | - R I Wu
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health system and Perelman School of Medicine, Philadelphia, Pennsylvania
| | - A L Moreira
- Department of Pathology, New York University Langone Health, New York, New York
| |
Collapse
|
5
|
DNA Methylation as a Noninvasive Epigenetic Biomarker for the Detection of Cancer. DISEASE MARKERS 2017; 2017:3726595. [PMID: 29038612 PMCID: PMC5605861 DOI: 10.1155/2017/3726595] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/10/2017] [Accepted: 08/07/2017] [Indexed: 12/30/2022]
Abstract
In light of the high incidence and mortality rates of cancer, early and accurate diagnosis is an important priority for assigning optimal treatment for each individual with suspected illness. Biomarkers are crucial in the screening of patients with a high risk of developing cancer, diagnosing patients with suspicious tumours at the earliest possible stage, establishing an accurate prognosis, and predicting and monitoring the response to specific therapies. Epigenetic alterations are innovative biomarkers for cancer, due to their stability, frequency, and noninvasive accessibility in bodily fluids. Epigenetic modifications are also reversible and potentially useful as therapeutic targets. Despite this, there is still a lack of accurate biomarkers for the conclusive diagnosis of most cancer types; thus, there is a strong need for continued investigation to expand this area of research. In this review, we summarise current knowledge on methylated DNA and its implications in cancer to explore its potential as an epigenetic biomarker to be translated for clinical application. We propose that the identification of biomarkers with higher accuracy and more effective detection methods will enable improved clinical management of patients and the intervention at early-stage disease.
Collapse
|
6
|
Roy M, Agarwal S, Mridha AR, Arora J, Madan K, Jain D, Mathur S. Metastatic ampullary adenocarcinoma in exfoliative sputum cytology: A rare presentation. Lung India 2015; 32:535-7. [PMID: 26628782 PMCID: PMC4587022 DOI: 10.4103/0970-2113.164175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Maitrayee Roy
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India E-mail:
| | - Shipra Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India E-mail:
| | - Asit Ranjan Mridha
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India E-mail:
| | - Jyoti Arora
- Department of Radiology, Medanta Medicity Hospital, Gurgaon, Haryana, India
| | - Karan Madan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India E-mail:
| | - Sandeep Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India E-mail:
| |
Collapse
|
7
|
Barril S, Sebastián L, Cotta G, Crespo A, Mateus E, Torrejón M, Ramos-Barbón D, Plaza V. Utility of Induced Sputum in Routine Clinical Practice. Arch Bronconeumol 2015; 52:250-5. [PMID: 26651625 DOI: 10.1016/j.arbres.2015.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the general and specific utility in diagnosis and/or treatment of induced sputum (IS) inflammatory cell counts in routine clinical practice. METHODS Retrospective study of 171 patients referred for clinical sputum induction over a 1-year period in the pulmonology department of a referral hospital. Independent observers established whether the information provided by IS inflammatory cell count was useful for making diagnostic and therapeutic decisions. RESULTS The most frequent reasons for determination of IS inflammatory cell count were: asthma 103 (59.20%); uncontrolled asthma 34 (19.54%); chronic cough 19 (10.9%), and gastroesophageal reflux 15 (8.6%). In 115 patients (67.3%) it was generally useful for diagnosis and/or treatment; in 98 patients (57.3%) it provided diagnostic information and in 85 patients (49.7%) it assisted in therapeutic decision-making. In asthma, uncontrolled asthma, chronic cough and gastroesophageal reflux, the results were useful in 71.8%, 67.6%, 47.4% and 60%, respectively. CONCLUSION The information provided by IS inflammatory cell count is extremely useful in clinical practice, especially in asthma and chronic cough. These results may justify the inclusion of the IS technique in pulmonology departments and asthma units of referral centers.
Collapse
Affiliation(s)
- Silvia Barril
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Laura Sebastián
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Gianluca Cotta
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Astrid Crespo
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Eder Mateus
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Montserrat Torrejón
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - David Ramos-Barbón
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Vicente Plaza
- Unidad de Asma y Alergia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
| |
Collapse
|
8
|
Izumchenko E, Chang X, Brait M, Fertig E, Kagohara LT, Bedi A, Marchionni L, Agrawal N, Ravi R, Jones S, Hoque MO, Westra WH, Sidransky D. Targeted sequencing reveals clonal genetic changes in the progression of early lung neoplasms and paired circulating DNA. Nat Commun 2015; 6:8258. [PMID: 26374070 PMCID: PMC4595648 DOI: 10.1038/ncomms9258] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 08/03/2015] [Indexed: 01/01/2023] Open
Abstract
Lungs resected for adenocarcinomas often harbour minute discrete foci of cytologically atypical pneumocyte proliferations designated as atypical adenomatous hyperplasia (AAH). Evidence suggests that AAH represents an initial step in the progression to adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA) and fully invasive adenocarcinoma. Despite efforts to identify predictive markers of malignant transformation, alterations driving this progression are poorly understood. Here we perform targeted next-generation sequencing on multifocal AAHs and different zones of histologic progression within AISs and MIAs. Multiregion sequencing demonstrated different genetic drivers within the same tumour and reveal that clonal expansion is an early event of tumorigenesis. We find that KRAS, TP53 and EGFR mutations are indicators of malignant transition. Utilizing droplet digital PCR, we find alterations associated with early neoplasms in paired circulating DNA. This study provides insight into the heterogeneity of clonal events in the progression of early lung neoplasia and demonstrates that these events can be detected even before neoplasms have invaded and acquired malignant potential. Atypical adenomatous hyperplasia is thought to be a precursor lesion for lung adenocarcinoma. Here, using targeted deep sequencing, the authors demonstrate that hyperplastic lesions contain somatic mutations associated with malignant disease and that these can be detected in circulating tumour cells.
Collapse
Affiliation(s)
- Evgeny Izumchenko
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - Xiaofei Chang
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - Mariana Brait
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - Elana Fertig
- Division of Biostatistics and Bioinformatics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Luciane T Kagohara
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - Atul Bedi
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - Luigi Marchionni
- Center for Computational Genomics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - Nishant Agrawal
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - Rajani Ravi
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - Sian Jones
- Personal Genome Diagnostics, Inc., 2809 Boston Street, Suite 503, Baltimore, Maryland 21224, USA
| | - Mohammad O Hoque
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| | - William H Westra
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21231, USA
| | - David Sidransky
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA.,Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA
| |
Collapse
|
9
|
Affiliation(s)
- Naveen Dutt
- Department of Respiratory Medicine, BPS Medical College, Khanpur, Haryana, India E-mail:
| | | |
Collapse
|
10
|
Lee GD, Kim HC, Kim YE, Lee SJ, Cho YJ, Jeong YY, Jeon KN, Jang IS, Lee JD, Hwang YS. Value of cytologic analysis of bronchial washings in lung cancer on the basis of bronchoscopic appearance. CLINICAL RESPIRATORY JOURNAL 2012; 7:128-34. [DOI: 10.1111/j.1752-699x.2012.00293.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
11
|
Diagnosis and Staging of Lung and Pleural Malignancy — an Overview of Tissue Sampling Techniques and the Implications for Pathological Assessment. Clin Oncol (R Coll Radiol) 2009; 21:451-63. [DOI: 10.1016/j.clon.2009.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 11/03/2008] [Accepted: 03/24/2009] [Indexed: 11/19/2022]
|
12
|
Franke KJ, Nilius G, Ruhle KH. Transbronchial catheter aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer. Eur J Med Res 2009; 14:13-7. [PMID: 19258205 PMCID: PMC3352199 DOI: 10.1186/2047-783x-14-1-13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial catheter aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy. Methods We analysed the results of 51 consecutively examined patients (age 68.7 ± 8.8 yrs.) applying both methods. 48 of 51 peripheral lesions proved to be malignant, 34 of which measured > 3 cm in diameter and 14 ≤ 3 cm. Fluoroscopy provided guidance in biopsies for both techniques. Results The mean diameter of the lesion was 3.7 ± 1.5 cm. We were able to establish a correct diagnosis by TBCA in 36 of 48 patients with lung cancer, and in 21 of 48 patients by TBB (75% vs. 44%, p < 0.01, chi-square-test). By combination of both methods 39 of 48 patients were correctly diagnosed. For carcinoma > 3 cm the success rate for TBCA was 76% (26/34) and for TBB 56% (19/34). For carcinoma ≤ 3 cm the success rate for TBCA was 71% (10/14) and for TBB 14% (2/14). Conclusions Even in lesions ≤ 3 cm application of TBCA results in an only marginally lower success rate compared to lesions > 3 cm. Due to the overall high success rate we suggest to apply the easy-to-handle and inexpensive method of TBCA in diagnostic procedure of peripheral lung carcinoma.
Collapse
Affiliation(s)
- Karl-Josef Franke
- Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, University of Witten/Herdecke, Ambrocker Weg 60, 58091 Hagen, Germany.
| | | | | |
Collapse
|
13
|
Jacomelli M, Souza R, Pedreira Júnior WL. Abordagem diagnóstica da tosse crônica em pacientes não-tabagistas: diagnostic approach. ACTA ACUST UNITED AC 2003. [DOI: 10.1590/s0102-35862003000600016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A tosse, como mecanismo fisiológico, tem fundamental importância na remoção das secreções respiratórias, constituindo, assim, um dos mecanismos de defesa pulmonar. No entanto, os quadros de tosse crônica constituem uma das principais causas de procura por assistência médica no mundo, o que ressalta o significado da correta identificação e tratamento dos fatores desencadeantes e/ou perpetuadores. Dentre os vários fatores relacionados aos quadros de tosse crônica, alguns assumem papel de relevada importância, tais como o refluxo gastroesofágico, a rinorréia posterior ou a asma, já que, isolada ou conjuntamente, constituem cerca de 95% das causas. O passo fundamental para o sucesso terapêutico nos quadros de tosse crônica é uma abordagem diagnóstica racional, que investigue a tosse crônica de maneira progressiva, permitindo, assim, a instituição do tratamento de forma mais custo-efetiva. Para isso, a proposta de um algoritmo a ser seguido serve como base para essa investigação inicial.
Collapse
|
14
|
Abstract
Conventional sputum cytology can be used for the detection of lung cancer, but has shown a low yield in prospective screening trials. This review focuses on the technical aspects relevant to the outcome of DNA and image analysis in sputum. Published articles are discussed in the light of the technical background. Recent developments in DNA analysis and nuclear image analysis show a clear potential to improve or refine diagnosis beyond that achieved with conventional sputum cytology examination. The challenge for future studies in DNA and nuclear analysis of sputum is to ensure high levels of quality control and to confirm these initial encouraging results.
Collapse
|