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Kim, Kim, Shi, Kim, Yoo, Kim, Kim, Kim, An, and Lee: A Comparison of Conventional Cytology and ThinPrep Cytology of Bronchial Washing Fluid in the Diagnosis of Lung Cancer
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(6): 523-530.

Published online: 30 June 2007

DOI: https://doi.org/10.4046/trd.2007.62.6.523

A Comparison of Conventional Cytology and ThinPrep Cytology of Bronchial Washing Fluid in the Diagnosis of Lung Cancer

Sang-Hoon Kim, M.D.1, Eun Kyung Kim, M.D.1, Kyeh-Dong Shi, M.D.1, Jung-Hyun Kim, M.D.1, Jeong-Hwan Yoo, M.D.1, Kyung Soo Kim, M.D.1, Joo-Young Kim, M.D.1, Gwang-Il Kim, M.D.2, Hee-Jung An, M.D.2, Ji-Hyun Lee, M.D.1

1Department of Internal Medicine, College of Medicine, Pochon CHA University, Sungnam, Korea.

2Department of Pathology, College of Medicine, Pochon CHA University, Sungnam, Korea.

Address for correspondence: Ji-Hyun Lee, M.D. Division of Pulmonology & Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, Pochon CHA University, 351 Yatap-dong, Bundang-gu, Seongnam-si, Kyeonggi-do 463-712, Korea. Phone: 82-31-780-5220, FAX: 82-31-780-5219, plmjhlee@yahoo.co.kr

Received 5 April 2007       Accepted 16 May 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

A ThinPrep® Processor was developed to overcome the limitations of conventional cytology and is widely used to diagnose various cancers. This study compared the diagnostic efficacy of conventional cytology for lung cancer with that of the ThinPrep® cytology using the bronchial washing fluid.

Methods

The bronchial washing fluid of 790 patients from Jan. 2002 to Dec. 2006, who were suspected of gaving a lung malignancy, was evaluated. Both ThinPrep® and conventional cytology were performed for all specimens.

Results

Four hundred forty-six men and 344 women were enrolled in this study, and 197 of them were diagnosed with cancer from either a bronchoscopic biopsy or a percutaneous needle aspiration biopsy. ThinPrep® cytology showed a sensitivity, specificity, positive predictive value, negative predictive value and false negative error rate of 71.1%, 98.0%, 92.1%, 91.1%, 8.9%, respectively. The conventional cytology showed sensitivity, specificity, positive predictive value, nagative predictive value and false negative error rate of 57.9%, 98.0%, 90.5%, 87.5%, 12.5%, respectively. For central lesions, the sensitivity of conventional cytology and ThinPrep® were 70.1% and 82.8%, respectively.

Conclusion

ThinPrep® cytology showed a higher sensitivity and lower false negative error rate than conventional cytology. This result was unaffected by the histological classification of lung cancer. Therefore, ThinPrep® cytology appears to be a useful method for increasing the detection rate of lung cancer in bronchial washing cytology test.

Keywords: Lung cancer, Bronchial washing, ThinPrep, Conventional cytology

Figures and Tables

Figure 1
Rate of positivity according to the histologic type.
trd-62-523-g001
Figure 2
Adenocarcinoma (Papanicolaou stain, ×400). (A) Conventional cytologic preparation (B) ThinPrep® preparation.
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Figure 3
Squamous cell carcinoma (Papanicolaou stain, ×400). (A) Conventional cytologic preparation (B) ThinPrep® preparation.
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Figure 4
Small cell carcinoma (Papanicolaou stain, ×200). (A) Conventional cytologic preparation (B) ThinPrep® preparation.
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Table 1
Histologic results of gold standard vs. conventional cytologic preparation and ThinPrep® preparation
trd-62-523-i001

*Conventional cytologic preparation, †ThinPrep® preparation.

Table 2
Diagnostic accuracy of conventional cytologic preparation and ThinPrep® preparation
trd-62-523-i002

*Conventional cytologic preparation, †ThinPrep® preparation.

Table 3
Results of CP and TP according to histologic type
trd-62-523-i003

*Conventional cytologic preparation, †ThinPrep® preparation.

Table 4
Rate of positivity according to the site of lesion
trd-62-523-i004

*conventional cytologic preparation, †ThinPrep® preparation.

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