Kemal K. BOZKURT, Korkut BOZKURT, Şirin BAŞPINAR, İ. Metin ÇİRİŞ, Sema BİRCAN, Nermin KARAHAN, F. Nilgün KAPUCUOĞLU

Primer akciğer tümörlerinde prebronkoskopik ve postbronkoskopik balgam sitolojileri

Amaç: Primer akciğer tümörü ön tanısıyla bronkoskopi yapılarak biyopsi alınan olguların prebronkoskopik ve postbronkoskopik balgam sitolojisi sonuçlarını histopatoloji sonuçlarıyla karşılaştırarak fakültemizde balgam sitolojilerinin etkinliğinin araştırılması. Materyal ve Metod: SDÜ Tıp Fakültesinde 2002-2005 yılları arasında bronkoskopi yapılarak biyopsi alınan 64 hastaya ait prebronkoskopik ve/veya postbronkoskopik balgam sitolojisi sonuçları histopatoloji sonuçlarıyla karşılaştırıldı. Sitoloji sonuçları benign, malignite kuşkulu, malign ve yetersiz olarak sınıflandırıldı. Bulgular: Incelenen 48 adet prebronkoskopik balgam örneğinin 37.si (%77.1) benign, 2.si (%4.2) yetersiz, 5.i (%10.4) malignite kuşkulu, 4.ü (%8.3) malign olarak rapor edilmiştir. Prebronkoskopik balgam sitolojisinin duyarlılığı %28.6, özgüllüğü %84.4, tanı değeri %67.4.dür. Incelenen 42 adet postbronkoskopik balgam örneğinden 32.si (%76.2) benign, 3.ü (%7.2) yetersiz, 6.sı malignite kuşkulu (%14.2), 1.i (%2.4) malign olarak rapor edilmiştir. Postbronkoskopik balgam sitolojisinin duyarlılığı %29.2, özgüllüğü %100, tanı değeri %56.4.dür. Sonuç: Balgam sitolojisi primer akciğer tümörlerinde ucuz ve noninvaziv bir tanı yöntemidir.

Anahtar Kelimeler:

Bronkoskopi, Biyopsi, Sitolojik teknikler, Akciğer neoplazmları, Geriyedönük çalışma, Balgam, Duyarlılık ve özgüllük

Prebronchoscopic and postbronchoscopic sputum cytologies in primary lung tumors

Purpose: To determine the utility of the sputum cytology in the evaluation of the primary lung tumors in our faculty by comparing the cytology results and histopathology results of patients who underwent bronchoscopy. Material and Method: We compared the prebronchoscopic and postbronchoscopic sputum cytology results and histopathology results of 64 patients who underwent bronchoscopy between 2002 and 2005 in Süleyman Demirel University School of Medicine. Cytology results were categorized as benign, suspicious for malignancy, malignant and insufficient. Results: The diagnosis of prebronchoscopic sputum cytology were benign, insufficient, suspicious for malignancy and malignant in 37(77.1%), 2(4.2%), 5(10.4%), 4(8.3%) cases respectively. Sensitivity, specificity, accuracy of the prebronchoscopic sputum cytology were 28.6%, 84.4%, 67.4% respectively. The diagnosis of postbronchoscopic sputum cytology were benign, insufficient, suspicious for malignancy and malignant in 32(76.2%), 3(7.2%), 6(14.2%), 1(2.4%) cases respectively. Sensitivity, specificity, accuracy of the prebronchoscopic sputum cytology were 29.2%, 100%, 56.4% respectively. Conclusion: Sputum cytology is a cheap and noninvazive diagnostic method for primary lung tumors.

Keywords:

Bronchoscopy, Biopsy, Cytological Techniques, Lung Neoplasms, Retrospective Studies, Sputum, Sensitivity and Specificity,

PDF

___

1. Lopez A. The lung cancer epidemic in developed countries. In: Lopez AD, Caselli G, Valkonen T. Adult mortality in developed countries: from description to explanation. Oxford, Oxford University Press, 1995; 111-134.
2. Ries LAG. Influence of extent of disease, histology and demographic factors on lung cancer survival in the SEER population-based data. Semin Surg Oncol 1994;10:21-30.
3. Wilde J. A 10 year follow-up of semi-annual screening for early detection of lung cancer in the Erfurt County, GDR. Eur Respir J 1989;2:656-662.
4. Fontana RS, Sanderson DR, Woolner LB, et al. Screening for lung cancer. A critique of the Mayo Lung project. Cancer 1991;67:1155-1164.
5. Rivera MP, Detterbeck F, Mehta AC. Diagnosis of Lung Cancer The Guidelines.Chest 2003; 123:129S-136S.
6. Jack CIA, Sheard JDH, Lippitt B, et al. Lung cancer in elderly patients: the role of induced sputum production to obtain a cytological diagnosis. Age and Aging 1993;22:227-229.
7. Khajotia RR, Mohn A, Schalleschak J, et al. Induced sputum and cytological diagnosis of lung cancer. Lancet 1991;338:976-977.
8. Yüksekol İ, Balkan A, Özkan M, Şevketbeyoğlu H, Bilgiç H, Ekiz K, Demirci N, Seber O. Periferik akciðer kanserlerinin tanýsýnda bronkoskopik lavaj, bronş biyopsisi ve postbronkoskopik balgam sitolojisinin tanı deðeri. Tüberküloz ve Toraks Dergisi 2003;51:258- 264.
9. Tockman MS, Mulshine JL. Sputum screening by quantitative microscopy: a new dawn for detection of lung cancer? Mayo Clin Proc 1997;72:788-90.
10. Midthun DF, Jett JR. Lung tumors. In: Albert RK, Spiro SG. Comprehensive Respiratory Medicine. London, Harcourt Brace and Company Limited, 1999; 843-927.
11. Bach PB, Kelley MJ, Tate RC, McCrory DC. Screening for Lung Cancer A Review of the Current Literature.Chest 2003;123:72S-82S.
12. Mehta AC, Marty JJ, Lee FYW. Sputum cytology in lung cancer. Clin Chest Med 1993;14:69-85.
13. Gilbert S, Douglas CM. Performance characteristics of different modalities for diagnosis of suspected lung cancer : Summary of published evidence. Chest 2003; 123: 115-128.
14. Koss LG. Tumors of the Lung: Conventional Cytology and Aspiration Biopsy. In: Koss LG. Diagnostic Cytology Vol:1, (4th Ed) Philadelphia, J.B. Lippincott Comp, 1992;849-855.