Prediction of Histological Subtypes of Invasive Lung Adenocarcinoma Using Preoperative Transbronchoscopic Cytology - Abstract
Objectives: To clarify the usefullnes of cytology in histological subtyping of invasive lung adenocarcinoma.
Materials and methods: Thirty-one specimens of resected invasive lung adenocarcinoma, diagnosed using transbronchoscopic cytology, were studied. Specimens were histologically classified into the primary and secondary histological subtypes according to the adenocarcinoma classification system proposed by the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society. Additionally, we prospectively classified cytological appearance of specimens into Grades 1-3, using both cell atypia and structual atypia. Grades corresponded to the following histological subtypes: Grade 1, lepidic histological subtype; Grade 2, acinar or papillary histological subtype; and Grade 3, solid histological subtype. The concordance between the assigned cytological grade and the histological subtype was analyzed.
Results: The concordances (number and rate) between the assigned cytological grade and the primary histological subtype were: Grade 1; 9 [77.8%], Grade 2; 13/20 [65.0%], and Grade 3; 2/2 [100%]. The concordances between the assigned cytological grade and the combination of both the primary and the secondary histological subtypes were: Grade 1; 8/9 [88.9%], Grade 2; 19/20 [95.0%].
Conclusions: Preoperative cytological analysis was a useful method for predicting the primary histological subtype for invasive lung adenocarcinomas.