Rapid on-site evaluation of transbronchial aspirates: Randomised comparison of two methods

Date
2010
Authors
Diacon A.H.
Koegelenberg C.F.N.
Schubert P.
Brundyn K.
Louw M.
Wright C.A.
Bolliger C.T.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
The value of different staining methods for rapid analysis of transbronchial needle aspirates during bronchoscopy has not been explored. In the present study, we compared a Papanicolaou-based rapid stain, prepared by a technologist and read by a cytopathologist, and a Wright-Giemsa-based rapid stain, prepared and read by a cytopathologist alone. Gold standard was the final laboratory report issued on each aspirate. We harvested 827 aspirates from 218 target sites in 126 consecutive patients. At least one positive aspirate was found in 99 (79%) patients. In those 99 patients, 288 of 574 (50%) aspirates were positive for neoplastic (83%) or non-neoplastic (17%) disease. False-negative aspirates and target sites were more frequent with the rapid Wright-Giemsa than with the rapid Papanicolaou stain (14.2 versus 7.3%, p=0.008, and 13.7 versus 3.6%, p=0.021, respectively). The sensitivity of the Wright-Giemsa-based and Papanicolaou-based rapid stains for detecting diagnostic material was 93 and 100% in patients, 83.1 and 95.5% in target sites, and 72.8 and 84.9% in aspirates, respectively. Specificity was 100% for both methods in patients and target sites, and 90.4 and 95% in aspirates. We concluded that a Papanicolaou-based stain has superior yield and accuracy to a Wright-Giemsa-based stain for rapid on-site evaluation of transbronchial needle aspirates. Copyright©ERS 2010.
Description
Keywords
adult, article, bronchoscopy, cytopathology, diagnostic accuracy, false negative result, female, Giemsa stain, gold standard, human, human cell, intermethod comparison, lung non small cell cancer, lung small cell cancer, lymphoma, major clinical study, male, neoplasm, Papanicolaou test, priority journal, randomization, sarcoidosis, sensitivity and specificity, transbronchial aspiration, tuberculosis, Wright Giemsa stain, Adenocarcinoma, Adult, Aged, Azure Stains, Biopsy, Needle, Bronchoscopy, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Cytodiagnosis, Female, Humans, Lung Neoplasms, Lymphoma, Male, Middle Aged, Predictive Value of Tests, Reference Standards, Reproducibility of Results, Sarcoidosis, Pulmonary, Sensitivity and Specificity, Staining and Labeling, Tuberculosis, Pulmonary
Citation
European Respiratory Journal
35
6