UICC World Cancer Congress 2006

Objective:To determine the diagnostic accuracy of examining bronchial lavage (BAL) and brushing in pulmonary cytopathology and whether BAL and brushing can complement each other in routine practice. Methods: A prospective study comparing 528 BAL and brushing results, conducted during 2001-2005. Tumors were confirmed by cytopathology, imaging techniques, or clinical outcome and imaging techniques combined. Results: 528 patients (374 men; 154 women) aged 65,3 years that underwent fibreoptic bronchoscopy for various pulmonary symptoms. Results: Exact concordance between BAL and brushing results was obtained in 443/508 (87,2%) satisfactory specimens. In 443 cases lung cancer was diagnosed by BAL cytology (329 men, 114 women; mean age 67,8 years). Lung tumors were separated into squamous cell carcinoma, adenocarcinoma, large cell carcinoma, small cell carcinomas, undifferentiated carcinoma. BAL specimens showed non-specific findings in 329 cases (74,3%) cases. No significant differences occurred in the number of brushings taken or in the bronchoscopic presentation of these cases. Except in one case (0,2%) of a false positive cytological result, malignancy was confirmed by repeated radiography and computed tomography. In 478 cases lung cancer was diagnosed by brushing alone (346 men, 132 women; mean age 64,30 years). Non-specific cytological disorders were found in 288 cases (60,3%). Examinations was repeated in 46 of the 528 patients either to confirm the initial results or to resolve apparent discrepancies between results and clinical data. Examination of bronchoalveolar lavages complements bronchial brushing cytopatholgy in both diagnosing and typing lung tumors and could be performed more systematically in patients undergoing fibreoptic bronchoscopy.