Possitivity Rate of Sputum Cytology Compared to Bronchoscopy and Transthoracic Needle Aspiration in Lung Cancer Patients at Wahidin Sudirohusodo Hospital, Indonesia

Fared Rofiansyah Noor, Harun Iskandar, M. Ilyas, A. Santoso, Erwin Arief, Nurjannah Lihawa, Bulkis Natsir
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Abstract

Introduction: Sputum cytology is the only non-invasive method which can detect early lung malignancies. The principle of it is a finding of cells shed from the lesion, either spontaneously or artificially. Aim: This study purposed to evaluate the positivity rate of sputum cytology compared to bronchoscopy or transthoracic needle aspiration (TTNA) in lung cancer patients. Place and Duration of Study: A prospective cross-sectional study used medical record data using SIRS from 2022 until completed or reached the desired number of samples at Wahidin Sudirohusodo General Hospital, Makassar. Methodology: Patients diagnosed with lung cancers, done a sputum cytology, and bronchoscopy/ TTNA were included. The patients had consented to be included in the study and the study had passed the ethical clearance from Hasanuddin Medical University Ethical Research Committee. Results: Of111 patients with lung cancer, which 46 patients (41,4%) were adenocarcinoma and the other 65 patients (58,6%) were squamous cell carcinoma. Patients with positive sputum cytology were 5 (4,5%), with tumor sizes ≥3cm were 107 patients (86%), and with a hemoptysis history was 59 patients (53,2%). The relationship between sputum cytology and histopathology, tumor size, and hemoptysis history were not significant (each p value >0.05). However, there was a relationship between sputum cytology and tumor location with a significant relationship between the two (p-value = 0.002). Conclusion: Sputum cytology is not recommended for diagnosing lung cancer due to low positivity rate, but the prediction rate is high which most likely is central squamous cell carcinoma.
印尼Wahidin Sudirohusodo医院肺癌患者痰细胞学检查与支气管镜检查和经胸针吸的阳性率比较
痰细胞学检查是唯一一种可以检测早期肺部恶性肿瘤的无创方法。它的原理是发现从病变中脱落的细胞,无论是自发的还是人为的。目的:本研究旨在评价肺癌患者痰细胞学检查与支气管镜检查或经胸穿刺(TTNA)检查的阳性率。研究地点和持续时间:一项前瞻性横断面研究使用SIRS从2022年开始的医疗记录数据,直到在望加锡Wahidin Sudirohusodo综合医院完成或达到所需的样本数量。方法:诊断为肺癌,进行痰细胞学检查和支气管镜检查/ TTNA的患者纳入研究。患者已同意纳入研究,该研究已通过Hasanuddin医科大学伦理研究委员会的伦理许可。结果:111例肺癌中,腺癌46例(41.4%),鳞状细胞癌65例(58.6%)。痰细胞学阳性5例(4.5%),肿瘤大小≥3cm 107例(86%),有咯血史59例(53.2%)。痰细胞学与组织病理学、肿瘤大小、咯血史的关系均无统计学意义(p值均为0.05)。然而,痰细胞学检查与肿瘤位置存在相关性,且两者之间存在显著相关性(p值= 0.002)。结论:痰细胞学检查阳性率低,不推荐用于肺癌的诊断,但预测率高,最可能为中央鳞状细胞癌。
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