Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

HanQingbing , ZhuHui , ShiJingyu , Yangsai , SunLin , WangXiaoqin , LuoYongxiao ,  WangKe

Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China;

Corresponding author：

WangKe, Email: wang2ke@126.com

Keywords：

Endobronchial ultrasound-guided transbronchial needle aspiration; Liquid-based cytology; Conventional cytology smear

DOI：

10.7507/1671-6205.2016064

Video：

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Objective To investigate whether liquid-based cytology (LBC) can improve diagnostic value of cytological assessment of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Methods A cohort of 600 cases who underwent EBUS-TBNA from June 2012 to September 2013 was enrolled in this prospective study in West China Hospital. EBUS-TBNA was carried out under local anesthesia and moderate sedation. The procedure was performed with echobronchoscopes. Histological tissues were stained with hematoxylin and eosin for further study. Additional immunohistological analysis was performed for establishing a reliable diagnosis as necessary. Aspirates were smeared on glass slides and separate aspirates were processed by the monolayer SurePath method. Results In total, 480 cases of malignant tumors and 120 cases of benign lesions were confirmed by histological examination. The sensitivity of SurePath liquid-based preparations and conventional smears was 82.1% and 56.0%, and the specificity was 87.5% and 82.5%, respectively. The combined specificity was 100.0%. The positive predictive value of two methods combined was 96.3% and 92.8%, whereas the negative predictive value was 54.9% and 31.9%, respectively. The difference between the two methods was significant (P < 0.05). Conclusions LBC preparation can improve cytological assessment of EBUS-TBNA. Histological study is necessary when the cytological diagnosis is obscure.

Citation： Han Qingbing, Zhu Hui, Shi Jingyu, Yang sai, Sun Lin, Wang Xiaoqin, Luo Yongxiao, Wang Ke. Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(3): 275-278. doi: 10.7507/1671-6205.2016064 Copy

1.	Yasufuku K, Chiyo M, Sekine Y, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest, 2004, 126:122-128.
2.	Ye T, Hu H, Luo X, et al. The role of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for qualitative diagnosis of mediastinal and hilar lymphadenopathy: a prospective analysis. BMC Cancer, 2011, 11:100.
3.	Gu P, Zhao YZ, Jiang LY, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer, 2009, 45:1389-1396.
4.	Adams K, Shah PL, Edmonds L, et al. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis. Thorax, 2009, 64:757-762.
5.	Navani N, Lawrence DR, Kolvekar S, et al. Endobronchial ultrasound-guided transbronchial needle aspiration prevents mediastinoscopies in the diagnosis of isolated mediastinal lymphadenopathy: a prospective trial. Am J Respir Crit Care Med, 2012, 186:255-260.
6.	Steinfort DP, Liew D, Conron M, et al. Cost-benefit of minimally invasive staging of non-small cell lung cancer: a decision tree sensitivity analysis. J Thorac Oncol, 2010, 5:1564-1570.
7.	Schmid-Bindert G, Wang Y, Jiang H, et al. EBUS-TBNA provides highest RNA yield for multiple biomarker testing from routinely obtained small biopsies in non-small cell lung cancer patients--a comparative study of three different minimal invasive sampling methods. PLoS One, 2013, 8:e77948.
8.	Navani N, Brown JM, Nankivell M, et al. Suitability of endobronchial ultrasound-guided transbronchial needle aspiration specimens for subtyping and genotyping of non-small cell lung cancer: a multicenter study of 774 patients. Am J Respir Crit Care Med, 2012, 185:1316-1322.
9.	Asano F, Aoe M, Ohsaki Y, et al. Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy. Respir Res, 2013, 14:50.
10.	Sakairi Y, Hoshino H, Fujiwara T, et al. Validation of EBUS-TBNA-integrated nodal staging in potentially node positive non-small cell lung cancer. Gen Thorac Cardiovasc Surg, 2013, 61: 522-527.
11.	Norimatsu Y, Kouda H, Kobayashi TK, et al. Utility of thin-layer preparations in the endometrial cytology: evaluation of benign endometrial lesions. Ann Diagn Pathol, 2008, 12:103-111.
12.	Hattori M, Kobayashi TK, Nishimura Y, et al. Comparative image analysis of conventional and thin-layer preparations in endometrial cytology. Diagn Cytopathol, 2013, 41:527-532.
13.	Norimatsu Y, Kouda H, Kobayashi TK, et al. Utility of liquid-based cytology in endometrial pathology: diagnosis of endometrial carcinoma. Cytopathology, 2009, 20:395-402.
14.	Takei H, Ruiz B, Hicks J. Cervicovaginal flora: comparison of conventional pap smears and a liquid-based thin-layer preparation. Am J Clin Pathol, 2006, 125:855-859.
15.	Norimatsu Y, Yanoh K, Kobayashi TK. The role of liquid-based preparation in the evaluation of endometrial cytology. Acta Cytol, 2013, 57:423-435.
16.	Beccati MD, Buriani C, Pedriali M, et al. Quantitative detection of molecular markers ProEx C (minichromosome maintenance protein 2 and topoisomerase IIa) and MIB-1 in liquid-based cervical squamous cell cytology. Cancer, 2008, 114:196-203.
17.	Natu S, Hoffman J, Siddiqui M, et al. The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience. J Clin Pathol, 2010, 63:445-451.
18.	Delattre C, Fournier C, Bouchindhomme B, et al. Endoscopic ultrasound guided transbronchial fine needle aspiration: a French Department of Pathology's 4-year experience. J Clin Pathol, 2011, 64:1117-1122.

1. Yasufuku K, Chiyo M, Sekine Y, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest, 2004, 126:122-128.
2. Ye T, Hu H, Luo X, et al. The role of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for qualitative diagnosis of mediastinal and hilar lymphadenopathy: a prospective analysis. BMC Cancer, 2011, 11:100.
3. Gu P, Zhao YZ, Jiang LY, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer, 2009, 45:1389-1396.
4. Adams K, Shah PL, Edmonds L, et al. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis. Thorax, 2009, 64:757-762.
5. Navani N, Lawrence DR, Kolvekar S, et al. Endobronchial ultrasound-guided transbronchial needle aspiration prevents mediastinoscopies in the diagnosis of isolated mediastinal lymphadenopathy: a prospective trial. Am J Respir Crit Care Med, 2012, 186:255-260.
6. Steinfort DP, Liew D, Conron M, et al. Cost-benefit of minimally invasive staging of non-small cell lung cancer: a decision tree sensitivity analysis. J Thorac Oncol, 2010, 5:1564-1570.
7. Schmid-Bindert G, Wang Y, Jiang H, et al. EBUS-TBNA provides highest RNA yield for multiple biomarker testing from routinely obtained small biopsies in non-small cell lung cancer patients--a comparative study of three different minimal invasive sampling methods. PLoS One, 2013, 8:e77948.
8. Navani N, Brown JM, Nankivell M, et al. Suitability of endobronchial ultrasound-guided transbronchial needle aspiration specimens for subtyping and genotyping of non-small cell lung cancer: a multicenter study of 774 patients. Am J Respir Crit Care Med, 2012, 185:1316-1322.
9. Asano F, Aoe M, Ohsaki Y, et al. Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy. Respir Res, 2013, 14:50.
10. Sakairi Y, Hoshino H, Fujiwara T, et al. Validation of EBUS-TBNA-integrated nodal staging in potentially node positive non-small cell lung cancer. Gen Thorac Cardiovasc Surg, 2013, 61: 522-527.
11. Norimatsu Y, Kouda H, Kobayashi TK, et al. Utility of thin-layer preparations in the endometrial cytology: evaluation of benign endometrial lesions. Ann Diagn Pathol, 2008, 12:103-111.
12. Hattori M, Kobayashi TK, Nishimura Y, et al. Comparative image analysis of conventional and thin-layer preparations in endometrial cytology. Diagn Cytopathol, 2013, 41:527-532.
13. Norimatsu Y, Kouda H, Kobayashi TK, et al. Utility of liquid-based cytology in endometrial pathology: diagnosis of endometrial carcinoma. Cytopathology, 2009, 20:395-402.
14. Takei H, Ruiz B, Hicks J. Cervicovaginal flora: comparison of conventional pap smears and a liquid-based thin-layer preparation. Am J Clin Pathol, 2006, 125:855-859.
15. Norimatsu Y, Yanoh K, Kobayashi TK. The role of liquid-based preparation in the evaluation of endometrial cytology. Acta Cytol, 2013, 57:423-435.
16. Beccati MD, Buriani C, Pedriali M, et al. Quantitative detection of molecular markers ProEx C (minichromosome maintenance protein 2 and topoisomerase IIa) and MIB-1 in liquid-based cervical squamous cell cytology. Cancer, 2008, 114:196-203.
17. Natu S, Hoffman J, Siddiqui M, et al. The role of endobronchial ultrasound guided transbronchial needle aspiration cytology in the investigation of mediastinal lymphadenopathy and masses, the North Tees experience. J Clin Pathol, 2010, 63:445-451.
18. Delattre C, Fournier C, Bouchindhomme B, et al. Endoscopic ultrasound guided transbronchial fine needle aspiration: a French Department of Pathology's 4-year experience. J Clin Pathol, 2011, 64:1117-1122.

Chinese Journal of Respiratory and Critical Care Medicine

Liquid-Based Cytology Preparation Can Improve Cytological Assessment of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

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