Introduction and utility of liquid‑based cytology on aspiration biopsy of peripheral nodular lesions of the lung

Imura,Johji; Abe,Kaori; Uchida,Yoshiaki; Shibata,Masaharu; Tsunematsu,Kazue; Sathoh,Motohiro; Miwa,Shigeharu; Nakajima,Takahiko; Nomoto,Kazuhiro; Hayashi,Shinichi; Tsuneyama,Koichi

doi:10.3892/ol.2013.1763

Introduction and utility of liquid‑based cytology on aspiration biopsy of peripheral nodular lesions of the lung

Authors:
- Johji Imura
- Kaori Abe
- Yoshiaki Uchida
- Masaharu Shibata
- Kazue Tsunematsu
- Motohiro Sathoh
- Shigeharu Miwa
- Takahiko Nakajima
- Kazuhiro Nomoto
- Shinichi Hayashi
- Koichi Tsuneyama
View Affiliations

Affiliations: Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930‑0194, Japan, Department of Pathology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan, Department of Radiology, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Japan
Published online on: December 17, 2013 https://doi.org/10.3892/ol.2013.1763
Pages: 669-673

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

In the present study, aspiration biopsy cytology (ABC) was used for the diagnosis of peripheral nodular lesions in the lung (PNLL), and liquid‑based cytology (LBC) was carried out on the material collected to evaluate it in comparison with the conventional method (CM). The subjects comprised 130 cases that underwent computed tomography (CT)‑guided ABC for PNLL. A total of 73 cases received a tumor resection, with a diagnosis based on the pathology, while 57 cases were followed up, as the tumor showed no change on the radiological examinations. Biopsy samples from these patients and lavage fluid from the aspiration needles were used for analysis. Cellular material was obtained by centrifugation of the lavage fluid, and samples were prepared by two methods, direct smearing and LBC according to the ThinPrep method. The samples were categorized into three diagnoses: i) Benign, ii) suspicion of malignancy and iii) malignant. Appropriate samples were collected in 72% of cases by LBC, but only in 36% of cases by the CM. There was no marked difference in cellular images between the two methods, with the exception of a few specific cases. LBC on its own provided sensitivity at 68%, specificity at 61% and accuracy at 65%, while a combination of LBC and biopsy markedly improved these figures to 94, 81 and 84%, respectively. The introduction of LBC is considered useful for the cytopathological diagnosis of PNLL by CT‑guided ABC. LBC enables the examination of appropriate samples rich in cellular components and supports a biopsy‑based diagnosis. A combination of these two methods provides even higher diagnostic accuracy, and LBC is considered an excellent method to evaluate these pathological samples.

View Figures

View References

1	Fassina A, Corradin M, Zardo D, Cappellesso R, Corbetti F and Fassan M: Role and accuracy of rapid on-site evaluation of CT-guided fine needle aspiration cytology of lung nodules. Cytopathology. 22:306–312. 2011. View Article : Google Scholar : PubMed/NCBI
2	Khouri NF, Stitik FP, Erozan YS, et al: Transthoracic needle aspiration biopsy of benign and malignant lung lesions. AJR Am J Roentgenol. 144:281–288. 1985. View Article : Google Scholar : PubMed/NCBI
3	Kothary N, Lock L, Sze DY and Hofmann LV: Computed tomography-guided percutaneous needle biopsy of pulmonary nodules: impact of nodule size on diagnostic accuracy. Clin Lung Cancer. 10:360–363. 2009. View Article : Google Scholar
4	Kirschner B, Simonsen K and Junge J: Comparison of conventional Papanicolaou smear and SurePath liquid-based cytology in the Copenhagen population screening programme for cervical cancer. Cytopathology. 17:187–194. 2006. View Article : Google Scholar
5	Rinas AC, Mittman BW Jr, Le LV, Hartmann K, Cayless J and Singh HK: Split-sample analysis of discarded cells from liquid-based Pap smear sampling devices. Acta Cytol. 50:55–62. 2006. View Article : Google Scholar : PubMed/NCBI
6	Fetsch PA, Simsir A, Brosky K and Abati A: Comparison of three commonly used cytologic preparations in effusion immunocytochemistry. Diagn Cytopathol. 26:61–66. 2002. View Article : Google Scholar
7	Joseph L, Edwards JM, Nicholson CM, Pitt MA and Howat AJ: An audit of the accuracy of fine needle aspiration using a liquid-based cytology system in the setting of a rapid access breast clinic. Cytopathology. 13:343–349. 2002. View Article : Google Scholar
8	Kontzoglou K, Moulakakis KG, Konofaos P, Kyriazi M, Kyroudes A and Karakitsos P: The role of liquid-based cytology in the investigation of breast lesions using fine-needle aspiration: a cytohistopathological evaluation. J Surg Oncol. 89:75–78. 2005. View Article : Google Scholar
9	Nasuti JF, Tam D and Gupta PK: Diagnostic value of liquid-based (Thinprep) preparations in nongynecologic cases. Diagn Cytopathol. 24:137–141. 2001. View Article : Google Scholar : PubMed/NCBI
10	Parfitt JR, McLachlin CM and Weir MM: Comparison of ThinPrep and conventional smears in salivary gland fine-needle aspiration biopsies. Cancer. 111:123–129. 2007. View Article : Google Scholar : PubMed/NCBI
11	Prétet JL, Vidal C, Le Bail Carval K, et al: Novaprep(®) Vial Test is a suitable liquid-based cytology medium for high risk human papillomavirus testing by Hybrid Capture 2. J Clin Virol. 49:286–289. 2010.
12	Valasoulis G, Koliopoulos G, Founta C, et al: Alterations in human papillomavirus-related biomarkers after treatment of cervical intraepithelial neoplasia. Gynecol Oncol. 121:43–48. 2011. View Article : Google Scholar
13	Apostolidou S, Hadwin R, Burnell M, et al: DNA methylation analysis in liquid-based cytology for cervical cancer screening. Int J Cancer. 125:2995–3002. 2009. View Article : Google Scholar
14	Komatsu K, Nakanishi Y, Seki T, et al: Application of liquid-based preparation to fine needle aspiration cytology in breast cancer. Acta Cytol. 52:591–596. 2008. View Article : Google Scholar : PubMed/NCBI
15	Imura J, Uchida Y, Tomita S, Ichikawa K and Fujimori T: Current and future of liquid based cytology. Pathol Clin Med. 27:1144–1151. 2009.(In Japanese).
16	Hwang EC, Park SH, Jung SI, et al: Usefulness of liquid-based preparation in urine cytology. Int J Urol. 14:626–629. 2007. View Article : Google Scholar : PubMed/NCBI
17	Lu DY, Nassar A and Siddiqui MT: High-grade urothelial carcinoma: comparison of SurePath liquid-based processing with cytospin processing. Diagn Cytopathol. 37:16–20. 2009. View Article : Google Scholar : PubMed/NCBI
18	Ylagan LR and Zhai J: The value of ThinPrep and cytospin preparation in pleural effusion cytological diagnosis of mesothelioma and adenocarcinoma. Diagn Cytopathol. 32:137–144. 2005. View Article : Google Scholar : PubMed/NCBI
19	Volmar KE, Vollmer RT, Routbort MJ and Creager AJ: Pancreatic and bile duct brushing cytology in 1000 cases: review of findings and comparison of preparation methods. Cancer. 108:231–238. 2006. View Article : Google Scholar : PubMed/NCBI
20	Konofaos P, Tomos P, Malagari K, et al: The role of ThinPrep cytology in the investigation of lung tumors. Surg Oncol. 15:173–178. 2006. View Article : Google Scholar : PubMed/NCBI
21	Wallace WA, Monaghan HM, Salter DM, Gibbons MA and Skwarski KM: Endobronchial ultrasound-guided fine-needle aspiration and liquid-based thin-layer cytology. J Clin Pathol. 60:388–391. 2007. View Article : Google Scholar : PubMed/NCBI
22	Kim S and Owens CL: Analysis of ThinPrep cytology in establishing the diagnosis of small cell carcinoma of lung. Cancer. 117:51–56. 2009.PubMed/NCBI
23	Wallace WA and Rassl DM: Accuracy of cell typing in nonsmall cell lung cancer by EBUS/EUS-FNA cytological samples. Eur Respir J. 38:911–917. 2011. View Article : Google Scholar : PubMed/NCBI
24	Iwasaki A, Kamihara Y, Yoneda S, Kawahara K and Shirakusa T: Video-assisted thoracic needle aspiration cytology for malignancy of the peripheral lung. Thorac Cardiovasc Surg. 51:89–92. 2003. View Article : Google Scholar : PubMed/NCBI
25	Harton AM, Wang HH, Schnitt SJ and Jacobs TW: p63 Immunocytochemistry improves accuracy of diagnosis with fine-needle aspiration of the breast. Am J Clin Pathol. 128:80–85. 2007. View Article : Google Scholar : PubMed/NCBI
26	Piaton E, Faÿnel J, Ruffion A, Lopez JG, Perrin P and Devonec M: p53 immunodetection of liquid-based processed urinary samples helps to identify bladder tumours with a higher risk of progression. Br J Cancer. 93:242–247. 2005. View Article : Google Scholar
27	Sartelet H, Lagonotte E, Lorenzato M, et al: Comparison of liquid based cytology and histology for the evaluation of HER-2 status using immunostaining and CISH in breast carcinoma. J Clin Pathol. 58:864–871. 2005. View Article : Google Scholar : PubMed/NCBI
28	Simsir A, Wei XJ, Yee H, Moreira A and Cangiarella J: Differential expression of cytokeratins 7 and 20 and thyroid transcription factor-1 in bronchioloalveolar carcinoma: an immunohistochemical study in fine-needle aspiration biopsy specimens. Am J Clin Pathol. 121:350–357. 2004. View Article : Google Scholar
29	Mian C, Lodde M, Comploj E, et al: Liquid-based cytology as a tool for the performance of uCyt+ and Urovysion Multicolour-FISH in the detection of urothelial carcinoma. Cytopathology. 14:338–342. 2003.PubMed/NCBI
30	Sui W, Ou M, Chen J, et al: Human telomerase RNA gene (TERC) gain and polysomy of chromosome 3 in cervicovaginal liquid-based pap preparations: a fluorescence in situ hybridization study. Eur J Gynaecol Oncol. 31:375–379. 2010.PubMed/NCBI
31	Billah S, Stewart J, Staerkel G, Chen S, Gong Y and Guo M: EGFR and KRAS mutations in lung carcinoma: molecular testing by using cytology specimens. Cancer Cytopathol. 119:111–117. 2011. View Article : Google Scholar : PubMed/NCBI
32	van Eijk R, Licht J, Schrumpf M, et al: Rapid KRAS, EGFR, BRAF and PIK3CA mutation analysis of fine needle aspirates from non-small-cell lung cancer using allele-specific qPCR. PLoS One. 6:e177912011.