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Year : 2022  |  Volume : 2  |  Issue : 1  |  Page : 17-24

Role of endobronchial needle aspiration cytology in diagnosing lung cancer in bronchoscopically visible tumors: A single-center study

1 Pulmonary Medicine, MIMSR Medical College, Latur, India
2 Department of Pathology, MIMSR Medical College, Latur, Maharashtra, India

Correspondence Address:
Shital Patil
FCCP (USA) Pulmonary Medicine, MIMSR Medical College, Latur 413512, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bjoc.bjoc_2_23

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Introduction: Bronchoscopy is an important diagnostic tool for the diagnosis of lung cancer, and various techniques have documented increase in diagnostic sensitivity. In this study, we have analyzed the role of bronchoscopy in diagnosis of lung cancer with special emphasis on endobronchial needle aspiration cytology (EBNA) in comparison to other conventional diagnostic techniques (CDTs) such as bronchial wash (BW) and forcep biopsy (FB). Materials and Methods: Prospective, observational study screened 1564 cases with suspected lung malignancy on clinical and radiological basis. Bronchoscopy-guided techniques such as EBNA, BW, and FB are used in exophytic endobronchial lesions (EELs) in confirming the diagnosis of lung cancer and to find additive yield over other techniques such as BW and FB. Rapid onsite evaluation (ROSE) analysis of all EBNA samples done in pathology lab allied center. Finally, histopathology proven 917 lung malignancy cases are included in this study. Statistical analysis is done by using chi-test. Results: In this study, 917 diagnosed lung cancer patients between 29 and 85 age group predominant 61.83% (567/917) and smokers by addiction in 52.12% (478/917) cases. Presented with cough in 80.80% (741/917), clubbing in 55.83% (512/917) cases, and mass lesion in chest radiograph in 53.10% (487/917) cases. Anatomical location is documented on the right side of tracheobronchial in 58.66% (538/917) cases during bronchoscopy. Yield of FB and FB plus BW in EEL is 86.69% (795/917) and 90.94% (834/917), respectively. Yield of EBNA, EBNA plus BW, and EBNA plus FB in EEL is 70.22% (644/917), 75.13% (689/917), and 97.16% (891/917), respectively. Overall yield of all bronchoscopy-guided techniques (EBNA + FB + BW) in our study in EEL is 100%. Additional yield of EBNA in EEL over other CDTs (FB plus BW) is 9.06%. Sensitivity of FB and EBNA in diagnosing lung malignancy in EEL is 86.69% and 70.22%, respectively. FB is more sensitive technique than EBNA in EEL (P < 0.00001). Sensitivity of FB plus BW in EEL is 90.94% (834/917). Sensitivity of EBNA plus BW in EEL is 75.13% (689/917). Sensitivity of EBNA plus FB in EEL is 97.16% (891/917) (P < 0.00001). Conclusion: EBNA is underutilized bronchoscopic technique in visible endobronchial lesions (exophytic endobronchial type) in spite of satisfactory diagnostic yield as compared with other CDTs. Although FB is most commonly preferred technique in bronchoscopically visible tumors, the addition of EBNA has improved overall diagnostic yield of bronchoscopy and decreased need for repeat bronchoscopy procedure.

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