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Correlation between brush cytology results and histopathological examination in diagnostic evaluation of precancerous conditions and laryngeal cancer: A prospective study

Paulina Lepka
Paulina Lepka
, 
Tomasz Zatoński
Tomasz Zatoński
, 
Szczepan Barnaś
Szczepan Barnaś
, 
Piotr Lepka
Piotr Lepka
 oraz 
Agnieszka Hałoń
Agnieszka Hałoń
   | 10 maj 2022
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Article Category: Original Study
Data publikacji: 10 maj 2022
Zakres stron: 149 - 156
Otrzymano: 09 wrz 2021
Przyjęty: 03 lut 2022
DOI: https://doi.org/10.2478/ahem-2022-0015
Słowa kluczowe
© 2022 Paulina Lepka et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Number (percentage) of patients in groups differing in terms of final and initial diagnosis on the basis of cytological examination results (FI – normal result, benign lesions; LSIL – low-grade lesion; HSIL – high-grade lesion; HSIL* – high-grade lesion with features of invasion; ASC-US – atypical cells of undetermined significance) and results of independence test
Number (percentage) of patients in groups differing in terms of final and initial diagnosis on the basis of cytological examination results (FI – normal result, benign lesions; LSIL – low-grade lesion; HSIL – high-grade lesion; HSIL* – high-grade lesion with features of invasion; ASC-US – atypical cells of undetermined significance) and results of independence test

Fig. 2

Number (percentage) of patients in groups differing in terms of clinical diagnosis and result of histopathological examination as well as result of independence test
Number (percentage) of patients in groups differing in terms of clinical diagnosis and result of histopathological examination as well as result of independence test

Fig. 3

Number (percentage) of patients in groups differing in terms of initial diagnosis and diagnosis made based on results of histopathological and cytological examination and results of independence test
Number (percentage) of patients in groups differing in terms of initial diagnosis and diagnosis made based on results of histopathological and cytological examination and results of independence test

Fig. 4

Scatter plot of cytology and histopathology results
Scatter plot of cytology and histopathology results

The accuracy of brush cytology as a diagnostic test for laryngeal cancer

Cytological examination The actual status – “gold standard” Histopathological examination
(+) (−) Total
(+) 40 (PD) 3 (FD) 43 (PD + FD)
(−) 4 (FU) 43 (PU) 47 (FU + PU)
44 (PD + FU) 46 (FD + PU) 87 (PD + FD + FFU + PU)

Observed numbers of the classification of laryngeal findings conducted by a cytologist and histopathologist, and Cohen’s kappa value with quadratic weights and standard errors for κ

Cytologist Histopathologist
Benign lesion LSIL HSIL Malignant lesion
Benign lesion 40 0 0 3
LSIL 4 7 0 0
HSIL 0 0 6 6
HISL with features of invasion 0 0 0 21
N = 87; Cohen’s kappa coefficient κ = 0.732; SE = 0.020; p < 0.0001

Cytological evaluation of laryngeal smear

Type of cytological preparation ConventionalMade using a different method
Overall quality of the smear Suitable for cytological evaluationSuitable for cytological evaluation, driedNot suitable for cytological evaluation (technical procedure was not performed, or technical procedure was performed but material is too dry, incorrectly preserved, cell concentration is low, material is not legible due to numerous inflammatory cells, erythrocytes)
Number of cells in the smear High cell concentration K1Moderate number of cells K2Low cell concentration K3
Erythrocyte count in the smear High erythrocyte count E1Low/moderate erythrocyte count E2Erythrocytes absent E3
Severity of inflammation Minor inflammation INF1Moderate inflammation INF2Severe inflammation INF3
Type of inflammatory cells Lymphocytes LGranulocytes GLymphocytes and granulocytes L and G
General characteristics of the smear No intraepithelial neoplasia or cancer, only normal stratified squamous epithelial cells are presentAbnormal cytologyCells other than stratified squamous epithelial cells are present in the smear, glandular epithelium cells are present
Abnormal epithelial cells Atypical squamous cells of undetermined significance ASC-USLow-grade intraepithelial lesion LSILHigh-grade squamous intraepithelial lesion HISLHigh-grade squamous intraepithelial lesion with features that raise suspicion of invasion (keratin pearl, keratin bundles, pathological mitoses)

Clinical characteristics of patients

Feature (variable) Group B Group K Total B vs K p
N = 67 N = 25 N = 92
n (%) n (%) n (%)
Diagnosis: <0.001
Laryngeal cancer 57 85.1 0 0.0 57 62.0
Leukoplakia 10 14.9 0 0.0 10 10.9
Polyp 0 0.0 10 40.0 10 10.9
Reinke’s edema 0 0.0 10 40.0 10 10.9
Cyst 0 0.0 5 20.0 5 5.3
Results of histopathological examination <0.001
FI - benign lesion 21 31.3% 25 100.0% 46 50.0%
LSIL 7 10.4% 0 0.0% 7 7.6%
HSIL 6 9.0% 0 0.0% 6 6.5%
Malignant lesion 33 49.3% 0 0.0% 33 35.9%
Results of cytological examination: N = 67 N = 23 N = 90 <0.001
FI - benign lesion 20 29.9% 23 100.0% 43 47.8%
LSIL 11 16.4% 0 0.0% 11 12.2%
HSIL 12 17.9% 0 0.0% 12 13.3%
HISL* (with features of invasion) 21 31.4% 0 0.0% 21 23.3%
ASC-US 3 4.5% 0 0.0% 3 3.3%

General characteristics of patients

Feature (variable) Group B Group K Total B vs K p
N = 67 N = 25 N = 92
n (%) n (%) n (%)
Sex: <0.001
Female 16 23.9% 18 72.0% 34 37,0%
Male 51 76.1% 7 28.0% 58 63,0%
Age: 0.011
M ± SD 64.1 ± 8.6 56.3 ± 14.4 62.0 ± 11.0
Me [Q1; Q3] 66 [60; 70] 59 [42; 67] 64 [57; 69]
Min – Max 26 - 79 34 - 85 26 - 85

Number (proportion) of diagnoses in 90 patients with laryngeal diseases made based on results of cytological and histopathological examinations

Result of brush cytology Result of histopathological examination
Benign lesionN = 44 LSILN = 7 HSILN = 6 Malignant lesionN = 33
FI - benign lesion 40 (44.4%) 0 (0.0%) 0 (0.0%) 3 (3.3%)
LSIL 4 (4.4%) 7 (7.8%) 0 (0.0%) 0 (0.0%)
HSIL 0 (0.0%) 0 (0.0%) 6 (6.7%) 6 (6.7%)
HISL* - with features of invasion 0 (0.0%) 0 (0.0%) 0 (0.0%) 21 (23.3%)
ASC-US - abnormal result 0 (0.0%) 0 (0.0%) 0 (0.0%) 3 (3.3%)
eISSN:
1732-2693
Język:
Angielski
Częstotliwość wydawania:
Volume Open
Dziedziny czasopisma:
Life Sciences, Molecular Biology, Microbiology and Virology, Medicine, Basic Medical Science, Immunology
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