Bronchogenic carcinoma was confirmed in each case by bronchial biopsy. There were three cases with squamous cell carcinoma, two of adenocarcinoma, and seven of small cell carcinoma (Table 1). In cach case there was agreement between the biopsy diagnosis and the cytologic evaluation of both the DST slides and the SBW slides. Enumeration of the malignant cells on each slide revealed that in each case there were substantially more cells on the SBW smears (30,477 ±44,569 malignant cells/slide, mean±SD) than on the DST smears (3,708±5,972 malignant cells/slide) (p<0.001, Fig 2). The SBW preparation was judged to be of higher quality in seven cases, the DST in one case and in the remaining four cases the quality of the two slides was felt to be equivalent (Table 1).
This study demonstrates a clear superiority of the Saccomanno brush wash kit over the traditional direct smear technique. An average of eight times more malignant cells was recovered with the SBW, and the quality of cellular detail was blindly judged to be better on the majority of the SBW preparations. It is particularly notable that these results were obtained in a study whose design was clearly biased in favor of the DST. It should be recalled that in each case the DST slides were prepared first, immediately at the completion of the brushing. The SBW slides were prepared with material which otherwise would have been discarded with the disposable brush. buy yaz online
It might be argued that these results are of limited clinical significance, since the study did not demonstrate any diagnostic difference between the two methods. However, this study clearly was not designed to address this question. The bronchial brush technique can be diagnostic with directly visualized lesions in over 90 percent of cases. Thus, to demonstrate clearly a diagnostic superiority ofone technique would require specimens from hundreds of such lesions.
Table 1—Comparison of Results of Cytologic Evaluation hy Direct Smear Technique (DST) and By Saccomanno Brush Wash (SBW) in Bronchogenic Carcinoma
|CaseNo.||CellTypei||No. of Cells DST*||No. of Cells, SBW||BetterPreserved±|
Figure 2. Quantitative evaluation of the malignant cells recovered in each case by SBW (solid bars) method and by DST (open bars) method. The number of cells recovered was consistently greater with SBW The difference for the two groups was significant (p<0.001).