Current status and impact of cytologic typing of lung cancer by bronchial brushing

Authors

Keywords:

lung cancer, bronchial brushing, endobronchial biopsy, effectiveness, typing

Abstract

Introduction: in the era of personalized treatment of lung cancer, accurate tumor typing is of vital importance. Cytological studies such as bronchial brushing are often the only way to establish the diagnosis.
Objective: to evaluate the efficacy of cytological typing of lung cancer with bronchial brushing without the use of immunohistochemical techniques.
Methods: an observational, descriptive, cross-sectional study was conducted at the "Arnaldo Milián Castro" Hospital of Villa Clara Province during the period from January 2017 to December 2019; a sample of 104 patients with concurrent bronchial brushing and endobronchial biopsy positive for lung cancer was included. Cytohistological concordance in lung cancer typing was evaluated and the effectiveness of cytological diagnosis for each subtype was determined.
Results: the subtype reported by brushing and endobronchial biopsy one were concordant in 75% of the cases. Among the discordant cases, squamous carcinomas misclassified as adenocarcinomas predominated. Inclassified specimens constituted 21%. The effectiveness in typing was 85% in adenocarcinomas, 87% in squamous carcinomas and 94% in small cell lung carcinomas.
Conclusions: bronchial brushing is an effective method for lung cancer typing. The diagnosis based on light microscopic morphology allows classification of a high percentage of cytological samples and the results are optimal with the joint evaluation of bronchial brushing and endobronchial biopsy.

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Author Biographies

Silvianne Vargas Gutiérrez, Hospital Universitario “Celestino Hernández Robau”

Especialista de I Grado en Anatomía Patológica. Profesora Instructora en la Universidad de Ciencias Médicas de Villa Clara.

Lissette Ruiz Jorge, Hospital Provincial Clínico Quirúrgico Universitario "Arnaldo Milián Castro"

Especialista de I y II Grado en Anatomía Patológica. Doctora en Ciencias Médicas. Profesora Titular en la Universidad de Ciencias Médicas de Villa Clara.

Daniel Artiles Martínez, Hospital Provincial Clínico Quirúrgico Universitario "Arnaldo Milián Castro"

Especialista de I Grado en Medicina General Integral. Especialista de I y II Grado en Anatomía Patológica. Máster en Citopatología. Profesor Asistente en la Universidad de Ciencias Médicas de Villa Clara.

References

1. Hoyos N, Montoro FJ, García JJ, Morales B, Pavón MJ. Cáncer de pulmón: ¿qué hay de nuevo? Rev Patol Respir [Internet]. 2017 [citado 09/07/2020];20(2):47-52. Disponible en: https://hp.dev3.link/revistadepatologiarespiratoria_detalle_articulo.php?aid=888

2. Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2017 [Internet]. La Habana: MINSAP; 2018 [citado 09/07/2020]. Disponible en: https://files.sld.cu/dne/files/2018/04/Anuario-Electronico-Espa%c3%b1ol-2017-ed-2018.pdf

3. Kumar V. Lung. In: Kumar V, Abbas AK, Aster JC. Robbins Basic Pathology. 9th. Philadelphia: Elsevier Saunders; 2013. p. 459-461.

4. Rekhtman N, Brandt SM, Sigel CS, Friedlander MA, Riely GJ, Travis WD, et al. Suitability of thoracic cytology for new therapeutic paradigms in non-small cell lung carcinoma: high accuracy of tumor subtyping and feasibility of EGFR and KRAS molecular testing. J Thorac Oncol. [Internet]. 2011 [citado 09/07/2020];6(3):451–458. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21266922/. https://doi.org/10.1097/jto.0b013e31820517a3

5. Chirieac LR, Attanoos RL. Usual Lung Cancers. In: Zander DS, Farver CF. Pulmonary Pathology. 2nd ed. Philadelphia: Elsevier; 2018. p. 534-551.

6. Barta JA, Powell CA, Wisnivesky JP. Global Epidemiology of Lung Cancer. Ann Glob Health [Internet]. 2019 [citado 09/07/2020];85(1):8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6724220/. https://doi.org/10.5334/aogh.2419

7. GK Nguyen, Smith B. Usual lung cancers. En: GK Nguyen, Smith B. Atlas & Text of Lung Cytology. 2nd ed. Canadá: ASCP; 2014 [citado 09/07/2020]. p. 61. Disponible en: https://file.pathology.ubc.ca/LUNGATLAS2014CPR.pdf

8. Zakowski MF, Rekhtman N, Auger M, Booth CN, Crothers B, Ghofrani M, et al. Morphologic Accuracy in Differentiating Primary Lung Adenocarcinoma From Squamous Cell Carcinoma in Cytology Specimens. Arch Pathol Lab Med [Internet]. 2016 [citado 09/07/2020];140(10):1116–1120. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539947/. https://doi.org/10.5858/arpa.2015-0316-oa

9. Núñez Crespo A. Estudio retrospectivo; Ecobroncoscopia (EBUS); aplicaciones y validación en el manejo, estadificación y tratamiento del cáncer pulmonar [tesis]. Bilbao: Universidad del País Vasco; 2017 [citado 09/07/2020]. Disponible en: https://addi.ehu.eus/bitstream/handle/10810/31022/TFG_Nunez_Crespo_Rev.pdf

10. Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart. 4th ed. [Internet]. Lyon: International Agency for Research on Cancer; 2015 [citado 09/07/2020]. Disponible en: https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/WHO-Classification-Of-Tumours-Of-The-Lung-Pleura-Thymus-And-Heart-2015

11. Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geinsinger KR, Yatabe Y. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol [Internet]. 2011 [citado 09/07/2020];6(2):244-285. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513953/. https://doi.org/10.1097/jto.0b013e318206a221

12. Travis WD, Rekhtman N. Pathological diagnosis and classification of lung cancer in small biopsies and cytology: strategic management of tissue for molecular testing. Semin Respir Crit Care Med [Internet]. 2011 [citado 09/07/2020];32(1):22–31. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21500121/. https://doi.org/10.1055/s-0031-1272866

13. Sigel CS, Moreira AL, Travis WD, Zakowski MF, Thornton RH, Riely GJ, et al. Subtyping of non-small cell lung carcinoma: a comparison of small biopsy and cytology specimens. J Thorac Oncol [Internet]. 2011 [citado 09/07/2020];6(11):1849–56. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21841504/. https://doi.org/10.1097/jto.0b013e318227142d

14. Vargas Gutiérrez S, Ruiz Jorge L. Valor diagnóstico de la citología del lavado y el cepillado bronquial en el cáncer de pulmón. Acta Méd Centro [Internet]. 2018 [citado 09/07/2020];12(1):1-9. Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/875/1102

15. Galen R, Gambino SR. Beyond normality: the predictive value and efficiency of medical diagnosis. New York: John Wiley and Sons; 1975. p. 71-78.

16. Sakr L, Roll P, Payan MJ, Liprandi A, Dutau H, Astoul P, et al. Cytology-based treatment decision in primary lung cancer: Is it accurate enough? Lung Cancer [Internet]. 2012 [citado 10/04/2021];75(3):293-299. Disponible en: https://www.sciencedirect.com/science/article/pii/S0169500211004673. https://doi.org/10.1016/j.lungcan.2011.09.001

17. Flieder DB, Borczuk AC, Noguchi M. Adenocarcinoma of the lung. In: Hasleton P, Flieder DB. Spencer’s Pathology of the Lung. 6th ed. New York: Cambridge University Press; 2013 [citado 10/04/2021]. p. 1042-92. Disponible en: https://assets.cambridge.org/97805215/09954/frontmatter/9780521509954_frontmatter.pdf

18. DeMay RM. Respiratory Cytology. In: DeMay R. The Art & Science of Cytopathology. 2nd ed. Chicago: ASCP Press; 1996: p. 55-72.

19. Nizzoli R, Tiseo M, Gelsomino F, Bartolotti M, Majori M, Ferrari L, et al. Accuracy of fine needle aspiration cytology in the pathological typing of non-small cell lung cancer. J Thorac Oncol [Internet]. 2011 [citado 10/04/2021];6(3):489–93. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21258246/. https://doi.org/10.1097/jto.0b013e31820b86cb

20. Celik B, Bulut T, Khoor A. Subtyping of non-small cell lung cancer by cytology specimens: A proposal for resource-poor hospitals. Cytojournal [Internet]. 2019 [citado 10/04/2021];16:8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6501614/. https://doi.org/10.4103/cytojournal.cytojournal_19_18

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Published

2022-10-01

How to Cite

1.
Vargas Gutiérrez S, Ruiz Jorge L, Artiles Martínez D. Current status and impact of cytologic typing of lung cancer by bronchial brushing. Acta Méd Centro [Internet]. 2022 Oct. 1 [cited 2025 Jul. 3];16(4):602-13. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/1586

Issue

Vol. 16 No. 4 (2022): October-December

Section

Original Articles

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