Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Diagnostic Accuracy of Fine Needle Aspiration Cytology versus Concurrent Core Needle Biopsy in Evaluation of Intrathoracic Lesions: a Retrospective Comparative Study

  • Published : 2015.11.04
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Transthoracic fine needle aspiration (FNA) cytology and core needle biopsy (CNB) are two commonly used approaches for the diagnosis of suspected neoplastic intrathoracic lesions. This study compared the diagnostic accuracy of FNA cytology and concurrent CNB in the evaluation of intrathoracic lesions. Materials and Methods: We studied FNA cytology and concurrent CNB specimens of 127 patients retrospectively, using hematoxylin and eosin (H&E), immunohistochemistry, and, on certain occasions cytochemistry. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology and Laboratory Medicine as well as patient records. Diagnostic accuracy was calculated for each test. Results: Of 127 cases, 22 were inconclusive and excluded from the study. The remaining 105 were categorized into 73 (69.5%) malignant lesions and 32 (30.5%) benign lesions. FNA and CNB findings were in complete agreement in 63 cases (60%). The accuracy and confidence intervals (CIs) of FNA and CNB for malignant tumors were 86.3% (CI: 79.3-90.7) and 93.2% (CI: 87.3-96.0) respectively. For epithelial malignant neoplasms, a definitive diagnosis was made in 44.8% of cases by FNA and 80.6% by CNB. The diagnostic accuracy of CNB for nonepithelial malignant neoplasms was 83.3% compared with 50% for FNA. Of the 32 benign cases, we made specific diagnoses in 16 with diagnostic accuracy of 81.3% and 6.3% for CNB and FNA, respectively. Conclusions: Our findings suggest that FNA is comparable to CNB in the diagnosis of malignant epithelial lesions whereas diagnostic accuracy of CNB for nonepithlial malignant neoplasms is superior to that for FNA. Further, for histological typing of tumors and examining tumor origin, immunohistochemical work up plays an important role.

Keywords

References

  1. Arakawa H, Nakajima Y, Kurihara Y, Niimi H, Ishikawa T (1996). CT-guided transthoracic needle biopsy: a comparison between automated biopsy gun and fine needle aspiration. Clin Radiol, 51, 503-6. https://doi.org/10.1016/S0009-9260(96)80191-7
  2. Arnold B W, Zwiebel W J (2002). Percutaneous transthoracic needle biopsy complicated by air embolism. AJR Am J Roentgenol, 178, 1400-2. https://doi.org/10.2214/ajr.178.6.1781400
  3. Austin JH, Cohen MB (1993). Value of having a cytopathologist present during percutaneous fine-needle aspiration biopsy of lung: report of 55 cancer patients and meta-analysis of the literature. AJR Am J Roentgenol, 160, 175-7. https://doi.org/10.2214/ajr.160.1.8416620
  4. Beslic S, Zukic F, Milisic S (2012). Percutaneous transthoracic CT guided biopsies of lung lesions; fine needle aspiration biopsy versus core biopsy. Radiol Oncol, 46, 19-22
  5. Bocking A, Klose KC, Kyll HJ, Hauptmann S (1995). Cytologic versus histologic evaluation of needle biopsy of the lung, hilum and mediastinum: sensitivity, specificity and typing accuracy. Acta Cytol, 39, 463-71.
  6. Boskovic T, Stanic J, Pena-Karan S, et al (2014). Pneumothorax after transthoracic needle biopsy of lung lesions under CT guidance. J Thorac Dis, 6, 99-107
  7. Conces DJ Jr, Schwenk GR Jr, Doering PR, et al (1987). Thoracic needle biopsy: improved results utilizing a team approach. Chest, 91, 813-6. https://doi.org/10.1378/chest.91.6.813
  8. Demirci E, Daloglu F, Gundogdu C, et al (2013). Incidence and clinicopathologic features of primary lung cancer: a North- Eastern Anatolia region study in Turkey (2006-2012). Asian Pac J Cancer Prev, 14, 1989-93. https://doi.org/10.7314/APJCP.2013.14.3.1989
  9. Dennie CJ, Matzinger FR, Mariner JR, et al (2001). Transthoracic needle biopsy of the lung: results of early discharge in 506 outpatients. Radiology, 219, 247-51 https://doi.org/10.1148/radiology.219.1.r01ap11247
  10. Emami Razavi SH, Aaghajani H, Haghazali M, et al (2009). The most common cancers in Iranian women. Iranian J Publ Health, 38, 109-12.
  11. Gong Y, Sneige N, Guo M, Hicks ME, Moran CA (2006). Transthoracic fine-needle aspiration vs concurrent core needle biopsy in diagnosis of intrathoracic lesions: a retrospective comparison of diagnostic accuracy. Am J Clin Pathol, 125, 438-44. https://doi.org/10.1309/FK9XMJ19T036LJ70
  12. Greif J, Marmor S, Schwarz Y, Staroselsky AN (1999). Percutaneous core needle biopsy vs fine needle aspiration in diagnosing benign lung lesions. Acta Cytol, 43, 756-60. https://doi.org/10.1159/000331287
  13. Greif J, Marmur S, Schwarz Y, Man A, Staroselsky AN (1998). Percutaneous core cutting needle biopsy compared with fine-needle aspiration in the diagnosis of peripheral lung malignant lesions: results in 156 patients. Cancer, 84, 144-7. https://doi.org/10.1002/(SICI)1097-0142(19980625)84:3<144::AID-CNCR4>3.0.CO;2-O
  14. Hajdu SI, Melamed MR (1984). Limitations of aspiration cytology in the diagnosis of primary neoplasms. Acta Cytol, 28, 337-45.
  15. Hajmanoochehri F, Mohammadi N, Zohal MA, et al (2014). Epidemiological and Clinicopathological Characteristics of Lung Cancer in a Teaching Hospital in Iran. Asian Pac J Cancer Prev, 15 (6), 2495-2500
  16. Heilo A (1993). Tumors in the mediastinum: US-guided histologic core-needle biopsy. Radiology, 189, 143-6. https://doi.org/10.1148/radiology.189.1.8372184
  17. Jemal A, Bray F, Center M, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  18. Khouri NF, Stitik FP, Erozan YS, et al (1985). Transthoracic needle aspiration biopsy of benign and malignant lung lesions. AJR Am J Roentgenol, 144, 281-8. https://doi.org/10.2214/ajr.144.2.281
  19. Kim HK, Shin BK, Cho SJ, et al (2002) .Transthoracic fine needle aspiration and core biopsy of pulmonary lesions. A study of 296 patients. Acta Cytol, 46, 1061-8. https://doi.org/10.1159/000327108
  20. Kravtsov V, Sukmanov I, Yaffe D, et al (2014). Diagnostic aspects of fine needle aspiration for lung lesions: series of 245 cases. Asian Pac J Cancer Prev, 15, 9865-9 https://doi.org/10.7314/APJCP.2014.15.22.9865
  21. Montezuma D, Azevedo R, Lopes P, et al (2013). A panel of four immunohistochemical markers (CK7, CK20, TTF-1, and p63) allows accurate diagnosis of primary and metastatic lung carcinoma on biopsy specimens. Virchows Arch, 463, 749-54. https://doi.org/10.1007/s00428-013-1488-z
  22. Moulton JS, Moore PT (1993). Coaxial percutaneous biopsy technique with automated biopsy devices: value in improving accuracy and negative predictive value. Radiology, 186, 515-22. https://doi.org/10.1148/radiology.186.2.8421758
  23. Mousavi SM, Gouya MM, Ramazani R, et al (2009). Cancer incidence and mortality in Iran. Ann Oncol, 20, 556-63.
  24. Nasuti JF, Gupta PK, Zubair WB (2002).Diagnostic value and cost-effectiveness of on site evaluation of fine-needle aspiration specimens: review of 5.688 cases. Diagn Cytopathol, 27, 1-4. https://doi.org/10.1002/dc.10065
  25. Norenberg R, Claxton CP Jr, Takaro T (1974). Percutaneous needle biopsy of the lung: report of two fatal complications. Chest, 66, 216-8. https://doi.org/10.1378/chest.66.2.216
  26. Pappa VI, Hussain HK, Reznek RH, et al (1996). Role of image guided core-needle biopsy in the management of patients with lymphoma. J Clin Oncol, 14, 2427-30.
  27. Sagel SS, Ferguson TB, Forrest JV, et al (1978). Percutaneous transthoracic aspiration needle biopsy. Ann Thorac Surg, 26, 399-405. https://doi.org/10.1016/S0003-4975(10)62917-7
  28. Spira A, Ettinger DS (2004). Multidisciplinary management of lung cancer. N Engl J Med, 50, 379-392.
  29. Stewart CJ, Stewart IS (1996). Immediate assessment of fine needle aspiration cytology of lung. J Clin Pathol, 49, 839-843. https://doi.org/10.1136/jcp.49.10.839
  30. World Health Organization (2013). Cancer. Factsheet.
  31. Wallace AB, Suh RD (2004). Percutaneous transthoracic needle biopsy: special considerations and techniques used in lung transplant recipients. Semin Intervent Radiol, 21, 247-58. https://doi.org/10.1055/s-2004-861559
  32. Yao X, Gomes MM, Tsao MS, et al (2012). Fine-needle aspiration biopsy versus core-needle biopsy in diagnosing lung cancer: A systematic review. Current oncology, 19, 16-27
  33. Zahir ST, Mirtalebi M (2012).Survival of patients with lung cancer, Yazd, Iran. Asian Pac J Cancer Prev, 13, 4387-91. https://doi.org/10.7314/APJCP.2012.13.9.4387