Possibilities of exfoliative cytological diagnostics depending on the growth pattern of lung cancer
Summary. Introduction. Lung cancer (LC) is the most frequent oncological disease in the world and Ukraine. The high mortality rate from it also persists. Treatment of LC is prescribing only after morphological (cytological or histological) verification. The first step on the way to clarify the nature of the pathological process in the lung is a cytological examination of the material (smears and bronchial washings) obtained by performing flexible bronchoscopy. The aim of our study was to analyze the results of cytological diagnostics using exfoliative material. Materials and methods. The analysis of the results of cytological diagnostics obtained by flexible bronchoscopy in 776 patients who were examined and treated at the National Cancer Institute in 2016 was carried out. The average age of the patients was (60.92 ± 1.14). The preparations were stained according to the Pappenheim and Papanicolaou methods. Results and discussion. The histological type of LC was established in 195 (25%), in 24 (3.5%) — a suspicion of LC was expressed in the cytological report, in 35 (4.5%) patients a descriptive type of cytological conclusion was observed. The largest group consisted of 522 (67%) patients, in whose cytological preparations only the cylindrical epithelium was detected, that is, the unchanged lining epithelium of the bronchial mucosa was identified. This fact justified the need to compare the data obtained with the results of the surgical material (scrapings of the surface of exophytic tumors in the bronchus were carried out), which made it possible to identify cancer cells in 9 (28%) of 31 patients, in the rest — 22 (72%) — only cells of the cylindrical epithelium. Conclusions. The fact that we have established that the results of exfoliative cytological diagnostics depend on the proliferation of LC of the bronchial mucosa, which has not yet been presented in the special literature. The results of the study allow us to state that exfoliative cytological diagnostics is possible in 28%–33% of cases and depends on the degree of tumor invasion in to the bronchial mucosa. The revealed growth of LC under the bronchial mucosa is directly relate do the further study of LC histogenesis, which is an important aspect in the future development of fundamental and applied oncomorphology and oncopulmonology.
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