Fiberoptic Bronchoscopy: Correlation of Cytology and Biopsy Results

Authors

1 Department of Clinical Anatomical Pathology,

2 Lung Transplantation Research Center

3 Mycobateriology Research Center

4 Department of Pulmonary Medicine

5 Tracheal Disease Research Center

6 Department of Clinical Anatomical Pathology

7 Tobacco Prevention and Control Research Center, NRITLD, Shaheed Beheshti University of Medical Sciences and Health Services, TEHRAN-IRAN

Abstract

Background: Fiberoptic bronchoscopy is a diagnostic method for respiratory diseases. At present, its diagnostic yield has been increased by different cytologic and histologic procedures by convention. Objective: This study was conducted to evaluate the concordance and agreement between cytologic and histologic findings in conventional diagnostic bronchoscopic methods (washing and biopsy) for lung malignancies. Materials and Methods: This was a cross-sectional study performed on 2076 cases of bronchial biopsy and bronchial washing between 1996 and 2003. Results: Of 2163 patients who underwent fiberoptic bronchoscopy after omitting 87(4%) cases due to unsatisfactory specimens, 2076 cases were studied including 832 (36.9%) females and 1244 (63.1%) males in the age range of 2 to 100 years, ( mean age 57.7±16.3 yrs). Male to female ratio was 1.5. Malignancy was diagnosed in 657(31.6%) biopsy and 283(13.6%) cytology specimens. Two hundred and sixty-five cases had malignant lesions according to both bronchial biopsy and bronchial washing; therefore, Kappa coefficient in both methods was 46.7% (P value = 0.000). Concordance rate was 77.4%. Ninety-seven point three percent of malignant cases were diagnosed by biopsy and 41.9% by cytology. Cytology contributed to an additional diagnostic rate of 2.6%. Conclusion: Kappa agreement is classified as fair and although there is a very good concordance between the two sampling techniques, the diagnostic yield of cytology for malignancy must be improved by combination of multiple assays. (Tanaffos 2007; 6(2): 46-50)

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