Cytological Diagnosis of Lung Cancer in Chiang Mai,
Thailand : Cyto-Histological Correlation and Comparison
of Sensitivity of Various Methods
SAMREUNG RANGDAENG, M.D.*, CHARIN YA-IN, M.D.*,
JONGKOLNEE SETTAKORN, M.D.*, BENJAPORN CHAIWUN, M.D.*,
CHAICHARN BHOTHIRAT, M.D.**, CHUSAK SIRIVANICHAI, M.D.***,
APINUN ARAMRA T ANA, M.D., Ph.D.****
Affiliation : * Department of Pathology,
** Department of Internal Medicine,
***Department of Radiology,
****Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
AbstractTo evaluate the role of cytology of sputum, bronchial brushing (BB), bronchial washing
(BW), bronchoalveolar lavage (BAL) and fine needle aspiration cytology (FNA) in the diagnosis
of lung cancer using histological material as a gold standard, a retrospective study was performed
on cytological materials obtained from 243 patients with possible lung cancer. Of these, 160 had been
confirmed histologically to have lung cancer. Cytological materials included in the study were 31
sputa, 123 BWs, 11 BBs and 36 BALs. Meanwhile, FNAs and concurrent gun biopsies (GBs) were
performed on 23 patients clinically and histologically proved to have lung cancer. The overall sensi
tivity of sputum, BW and BAL was 0.222, 0.455 and 0.361, respectively. BB provided a significantly
far superior sensitivity (0.800) than those of three former methods with p<0.05 by Fisher's exact test.
FNA and GB seemed to provide greater sensitivity of 0.913 and 0.783, respectively. Although the
complimentary role of various conventional cytological techniques is well recognized, bronchial
brushing is the only single technique that significantly improved diagnostic yield. FNA and GB
techniques should be encouraged due to their superior sensitivity.
Keywords : Lung Cancer, Cytology, Cyto-Histological Correlation
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