The role of cytological examination in the detection of lung tumors

Background: Lung cancer is a widespread group of tumor lesions characterized by late detection and high mortality rates, which determines the need for its effective diagnosis. Cytological examination is the primary link in the morphological verification of lung cancer, has a number of advantages and has high diagnostic indicators.

Aim: To evaluate the diagnostic potential of cytological examination in the detection of lung tumor lesions using samples of material obtained by various methods.

Materials and methods: A retrospective assessment of traditional cytological samples of lung material taken by various methods from 301 patients who were hospitalized and examined in 2018–2023 was carried out. The cytological picture was categorized using the terminological assessment system in respiratory cytopathology (World Health Organization, 2022) and the international reporting system for cytopathology of serous fluids in 2016. The diagnostic parameters of the method of cytological diagnosis of lung cancer were evaluated according to the following criteria: diagnostic sensitivity, diagnostic specificity, diagnostic effectiveness.

Results: The most common types of lung cancer in the study group were: squamous cell carcinoma — 123 cases (41.6% of the total number of primary and secondary lung cancer), adenocarcinoma — 94 (31.8%), small cell lung cancer — 29 (9.8%), carcinoid — 11 (3.7%). Cytological changes were categorized in accordance with international reporting systems, and the detectability of tumor changes was analyzed based on material obtained by various methods. Additionally, a correlation was made between the detected cytomorphological features in the most common forms of primary lung cancer in the study group and the literature data.

Conclusion: Without taking into account the material with the lowest diagnostic indicators, the diagnostic potential of cytological diagnosis in the detection of lung cancer was as follows: sensitivity — 87.6%, specificity — 98.6%, diagnostic effectiveness — 86.4%. The cytological diagnosis of brush biopsies, fine needle aspiration biopsy material, and prints from the biopsy and lung tissue has high diagnostic parameters, which determines the possibility of prioritizing the use of these types of material for primary morphological verification of lung cancer.