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

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

Postępy Higieny i Medycyny Doświadczalnej
Volume 76 (2022): Issue 1 (January 2022)
By: Paulina Lepka,  Tomasz Zatoński,  Szczepan Barnaś,  Piotr Lepka and  Agnieszka Hałoń  
Open Access
|May 2022

Figures & Tables

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 examinationThe 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

CytologistHistopathologist
Benign lesionLSILHSILMalignant lesion
Benign lesion40003
LSIL4700
HSIL0066
HISL with features of invasion00021
N = 87; Cohen’s kappa coefficient κ = 0.732; SE = 0.020; p < 0.0001

Cytological evaluation of laryngeal smear

Type of cytological preparationConventionalMade using a different method
Overall quality of the smearSuitable 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 smearHigh cell concentration K1Moderate number of cells K2Low cell concentration K3
Erythrocyte count in the smearHigh erythrocyte count E1Low/moderate erythrocyte count E2Erythrocytes absent E3
Severity of inflammationMinor inflammation INF1Moderate inflammation INF2Severe inflammation INF3
Type of inflammatory cellsLymphocytes LGranulocytes GLymphocytes and granulocytes L and G
General characteristics of the smearNo 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 cellsAtypical 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 BGroup KTotalB vs K p
N = 67N = 25N = 92
n(%)n(%)n(%)
Diagnosis: <0.001
Laryngeal cancer5785.100.05762.0
Leukoplakia1014.900.01010.9
Polyp00.01040.01010.9
Reinke’s edema00.01040.01010.9
Cyst00.0520.055.3
Results of histopathological examination <0.001
FI - benign lesion2131.3%25100.0%4650.0%
LSIL710.4%00.0%77.6%
HSIL69.0%00.0%66.5%
Malignant lesion3349.3%00.0%3335.9%
Results of cytological examination:N = 67N = 23N = 90<0.001
FI - benign lesion2029.9%23100.0%4347.8%
LSIL1116.4%00.0%1112.2%
HSIL1217.9%00.0%1213.3%
HISL* (with features of invasion)2131.4%00.0%2123.3%
ASC-US34.5%00.0%33.3%

General characteristics of patients

Feature (variable)Group BGroup KTotalB vs K p
N = 67N = 25N = 92
n(%)n(%)n(%)
Sex: <0.001
Female1623.9%1872.0%3437,0%
Male5176.1%728.0%5863,0%
Age: 0.011
M ± SD64.1 ± 8.656.3 ± 14.462.0 ± 11.0
Me [Q1; Q3]66 [60; 70]59 [42; 67]64 [57; 69]
Min – Max26 - 7934 - 8526 - 85

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

Result of brush cytologyResult of histopathological examination
Benign lesionN = 44LSILN = 7HSILN = 6Malignant lesionN = 33
FI - benign lesion40 (44.4%)0 (0.0%)0 (0.0%)3 (3.3%)
LSIL4 (4.4%)7 (7.8%)0 (0.0%)0 (0.0%)
HSIL0 (0.0%)0 (0.0%)6 (6.7%)6 (6.7%)
HISL* - with features of invasion0 (0.0%)0 (0.0%)0 (0.0%)21 (23.3%)
ASC-US - abnormal result0 (0.0%)0 (0.0%)0 (0.0%)3 (3.3%)
DOI: https://doi.org/10.2478/ahem-2022-0015 | Journal eISSN: 1732-2693
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Language: English
Page range: 149 - 156
Submitted on: Sep 9, 2021
|
Accepted on: Feb 3, 2022
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Published on: May 10, 2022
Published by: Hirszfeld Institute of Immunology and Experimental Therapy
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
brush cytology,
histopathological examination,
dysplasia,
laryngeal squamous carcinoma,
screening
Related subjects:
Life sciences,
Molecular biology,
Microbiology and virology,
Medicine,
Basic medical science,
Immunology

© 2022 Paulina Lepka, Tomasz Zatoński, Szczepan Barnaś, Piotr Lepka, Agnieszka Hałoń, published by Hirszfeld Institute of Immunology and Experimental Therapy
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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