DOI QR코드

DOI QR Code

Diagnostic Aspects of Fine Needle Aspiration for Lung Lesions: Series of 245 Cases

  • 발행 : 2014.12.18

초록

Background: Transthoracic fine needle aspiration (FNA) is one of several methods for establishing tissue diagnosis of lung lesions. Other tissue or cell sources for diagnosis include sputum, endobronchial biopsy, washing and brushing, endobronchial FNA, transthoracic core needle biopsy, biopsy from thoracoscopy or thoracotomy. The purpose of this study was to compare the sensitivity and specificity of FNA and other diagnostic tests in diagnosing lung lesions. Materials and Methods: The population included all patients undergoing FNA for lung lesions at Meir Medical Center from 2006 through 2010. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology, patient records and files from the Department of Oncology. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculated for each test. Results: FNA was carried out in 245 patients. Malignant tumors were diagnosed in 190 cases (78%). They included adenocarcinoma (43%), squamous cell carcinoma (15%), non-small cell carcinoma, not otherwise specified (19%), neurondocrine tumors (7%), metastases (9%) and lymphoma (3%). The specificity of FNA for lung neoplasms was 100%; sensitivity and diagnostic accuracy were 87%. Conclusions: FNA is the most sensitive procedure for establishing tissue diagnoses of lung cancer. Combination with core needle biopsy increases the sensitivity. Factors related to the lesion (nature, degenerative changes, location) and to performance of all stages of test affect the ability to establish a diagnosis.

키워드

참고문헌

  1. Afify A and Davila RM (1999). Pulmonary fine needle aspiration biopsy. Assessing the negative diagnosis. Acta Cytol, 43, 601-4. https://doi.org/10.1159/000331152
  2. Arslan S, Yilmaz A, Bayramgurler B et al (2002). CT-guided transthoracic fine needle aspiration of pulmonary lesions: accuracy and complications in 294 patients. Med Sci Monit, 8, 493-7.
  3. Demirci E, Daloglu F, Gundogdu C, et al (2013). Incidence and clinicopathologic features of primary lung cancer: a North- Eastern Anatolia region study in Turkey (2006-2012). Asian Pac J Cancer Prev, 14, 1989-93. https://doi.org/10.7314/APJCP.2013.14.3.1989
  4. Gill RK, Vazquez MF, Kramer A, et al (2008). The use of genetic markers to identify lung cancer in fine needle aspiration samples. Clin Cancer Res, 14, 7481-7. https://doi.org/10.1158/1078-0432.CCR-07-5242
  5. Gong Y, Sneige N, Guo M, Hicks ME, Moran CA (2006). Transthoracic fine-needle aspiration vs concurrent core needle biopsy in diagnosis of intrathoracic lesions: a retrospective comparison of diagnostic accuracy. Am J Clin Pathol, 125, 438-44. https://doi.org/10.1309/FK9XMJ19T036LJ70
  6. Guber A, Greif J, Rona R, et al (2010). Computerized analysis of cytology and fluorescence in situ hybridization (FISH) in induced sputum for lung cancer detection. Cancer Cytopathol, 118, 269-77. https://doi.org/10.1002/cncy.20094
  7. Haaga JR, Alfidi RJ (1976). Precise biopsy localization by computer tomography. Radiology, 118, 603-7. https://doi.org/10.1148/118.3.603
  8. Herth FJ, Ernst A, Becker HD (2002). Endobronchial ultrasoundguided transbronchial lung biopsy in solitary pulmonary nodules and peripheral lesions. Eur Respir J, 20, 972-4. https://doi.org/10.1183/09031936.02.00032001
  9. Hiraki T, Mimura H, Gobara H, et al (2009). CT fluoroscopyguided biopsy of 1,000 pulmonary lesions performed with 20-gauge coaxial cutting needles: diagnostic yield and risk factors for diagnostic failure. Chest, 136, 1612-17. https://doi.org/10.1378/chest.09-0370
  10. Kaya V, Yildirim M, Demirpence O, Yildiz M, Yalcin AY (2013). Prognostic significance of basic laboratory methods in nonsmall- cell-lung cancer. Asian Pac J Cancer Prev, 14, 5473-6. https://doi.org/10.7314/APJCP.2013.14.9.5473
  11. Kim HK, Shin BK, Cho SJ, et al (2002). Transthoracic fine needle aspiration and core biopsy of pulmonary lesions. A study of 296 patients. Acta Cytol, 46, 1061-8. https://doi.org/10.1159/000327108
  12. Layfield LJ, Coogan A, Johnston WW, Patz EF (1996). Transthoracic fine needle aspiration biopsy. Sensitivity in relation to guidance technique and lesion size and location. Acta Cytol, 40, 687-90. https://doi.org/10.1159/000333940
  13. Montezuma D, Azevedo R, Lopes P, et al (2013). A panel of four immunohistochemical markers (CK7, CK20, TTF-1, and p63) allows accurate diagnosis of primary and metastatic lung carcinoma on biopsy specimens. Virchows Arch, 463, 749-54. https://doi.org/10.1007/s00428-013-1488-z
  14. Mullan CP, Kelly BE, Ellis PK, et al (2004). CT-guided fineneedle aspiration of lung nodules: effect on outcome of using coaxial technique and immediate cytological evaluation. Ulster Med J, 73, 32-6.
  15. Nga ME, Lim GL, Barbro N, Chan NH (2005). Successful retrieval of fine-needle aspiration biopsy material from previously stained smears for immunocytochemistry: a novel technique applied to three soft tissue tumors. Mod Pathol, 18, 728-32. https://doi.org/10.1038/modpathol.3800356
  16. Savic S and Bubendorf L (2012). Role of fluorescence in situ hybridization in lung cancer cytology. Acta Cytol, 56, 611-21. https://doi.org/10.1159/000339792
  17. Senturk A, Babaoglu E, Kilic H, et al (2014). Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lymphoma. Asian Pac J Cancer Prev, 15, 4169-73. https://doi.org/10.7314/APJCP.2014.15.10.4169
  18. Skov BG, Kiss K, Ramsted J, Linnemann D (2009). A technique to improve diagnostic information from fine-needle aspirations: immunohistochemistry on cytoscrape. Cancer, 117, 120-7.
  19. Travis WD, Brambilla E, Riely GJ (2013). New pathologic classification of lung cancer: relevance for clinical practice and clinical trials. J Clin Oncol, 31, 992-1001. https://doi.org/10.1200/JCO.2012.46.9270
  20. Unal OU, Oztop I, Calibasi G, et al (2013). Relationship between epidermal growth factor receptor gene mutations and clinicopathological features in patients with non-small cell lung cancer in western Turkey. Asian Pac J Cancer Prev, 14, 3705-9. https://doi.org/10.7314/APJCP.2013.14.6.3705
  21. Yasufuku K, Nakajima T, Fujiwara T, et al (2008). Role of endobronchial ultrasound-guided transbronchial needle aspiration in the management of lung cancer. Gen Thorac Cardiovasc Surg, 56, 268-76. https://doi.org/10.1007/s11748-008-0249-4

피인용 문헌

  1. Diagnostic Accuracy of Fine Needle Aspiration Cytology versus Concurrent Core Needle Biopsy in Evaluation of Intrathoracic Lesions: a Retrospective Comparative Study vol.16, pp.16, 2015, https://doi.org/10.7314/APJCP.2015.16.16.7385
  2. Standardized terminology and nomenclature for respiratory cytology: The Papanicolaou Society of Cytopathology guidelines vol.44, pp.5, 2016, https://doi.org/10.1002/dc.23457