Akciğer kanseri tanısında indükte balgam ile spontan balgamın karşılaştırılması
Küçük Resim Yok
Tarih
2002
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Dergi ISSN
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Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Son yıllarda indükte balgam (IB), hava yolu inflamasyonuyla seyreden akciğer hastalıklarının tanı ve izleminde sıkça kullanılmasına karşın, akciğer kanseri tanısında kullanımıyla ilgili az sayıda çalışma bulunmaktadır. Bu çalışmada, radyolojik olarak akciğer kanseri düşünülen olgularda IB'nin tanısal değerinin araştırılması ve spontan balgam (SB) sonuçları ile karşılaştırılması amaçlanmıştır. Çalışmaya, Mart 1999-Aralık 2000 tarihleri arasında akciğer kanseri ön tanısıyla tetkik edilen 52 olgu (yaş ortalaması: 60.9 ± 10.3 yıl, erkek/kadın: 50/2) alınmıştır. Olgulardan önce SB, sonra jet nebülizör ile %3'lük hipertonik tuzlu su kullanılarak IB alınmıştır. Bir-yedi gün sonra işlemler yinelenmiş, ardından fiberoptik bronkoskopi (FOB) uygulanmıştır. Olguların yaş, sigara alışkanlığı, tümörün radyolojik ve bronkoskopik özellikleri ile tanı yöntemleri arasındaki ilişki araştırılmıştır. SB ve IB ile bronkoskopik materyallerin patoloji sonuçları birbirleriyle karşılaştırılmıştır. Olgulardan 44 (%84.6)'ü akciğer kanseri tanısı almıştır. Endobronşiyal tümör izlenen 6 olgu (%11.5), histopatolojik tanı konulamamasına karşın, radyolojik olarak tümör kabul edilmiştir. Birinci ve ikinci SB'lerin birbirlerine üstünlükleri olmadığı izlenirken, IB'lerden, 2. alınan daha fazla tanı koydurmuştur (p= 0.045). Hem 1. hem de 2. IB'lerin malignite tanısı koymada, aynı gün alınan SB'lerden daha fazla tanısal değeri olduğu gözlenmiştir (sırasıyla p= 0.015 ve p= 0.0005). Sonuç olarak; SB ve IB sitolojilerinin akciğer kanseri tanısı koymada, FOB'un yerini alması sözkonusu değildir. Ancak FOB yapılamayan ve histolojik tanı gereken hastalardan, noninvaziv bir yöntem olan IB'nin alınması önerilebilir.
Analysis of induced sputum (IS) has been adopted the past few years as a relatively noninvasive method for the evaluation of pulmonary disease with airway inflammation. There are only a few studies about its use in the diagnosis of lung cancer. The aim of this study was to determine the diagnostic value of IS and compare it with the results spontaneous sputum (SS) in patients who were considered to have lung cancer. We studied 52 patients (mean age: 60.9 ± 10.3 years, male/female: 50/2) suspected lung cancer. The patient expectoreted sputum, thereafter IS sample was obtained by using hypertonic saline (3%) via a jet nebulizer. After repeating same procedures one-seven days later, fiberoptic bronchoscopy (FOB) was performed. The relations between the age, smoking history, radiographic and bronchoscopic features of the tumour and the diagnostic procedures were evaluated. Besides, pathologic results of IS, SS and bronchoscopic specimens were compared to each other. Diagnosis of lung cancer was made in 44 patients (84.6%). Although histopathologic diagnosis could not be performed, the six patients who had endobronchial located tumour were assessed as radiologically tumour. There was no effect of the evaluated parameters on the cytologic results of the procedures. The examinations of the first and second SS samples were not superior to each other, whereas the diagnostic value of the second IS was better than the first one (p= 0.045). Besides, both samples of the IS had a higher diagnostic yield in the diagnosis of lung cancer than SS (p= 0.015 and p= 0.0005, respectively). IS and SS cytology can not take the place of FOB in the diagnosis of lung cancer. However, sputum induction could be used as a noninvasive method in patients in whom histological diagnosis is needed and fiberoptic bronchoscopy Is contraindicated.
Analysis of induced sputum (IS) has been adopted the past few years as a relatively noninvasive method for the evaluation of pulmonary disease with airway inflammation. There are only a few studies about its use in the diagnosis of lung cancer. The aim of this study was to determine the diagnostic value of IS and compare it with the results spontaneous sputum (SS) in patients who were considered to have lung cancer. We studied 52 patients (mean age: 60.9 ± 10.3 years, male/female: 50/2) suspected lung cancer. The patient expectoreted sputum, thereafter IS sample was obtained by using hypertonic saline (3%) via a jet nebulizer. After repeating same procedures one-seven days later, fiberoptic bronchoscopy (FOB) was performed. The relations between the age, smoking history, radiographic and bronchoscopic features of the tumour and the diagnostic procedures were evaluated. Besides, pathologic results of IS, SS and bronchoscopic specimens were compared to each other. Diagnosis of lung cancer was made in 44 patients (84.6%). Although histopathologic diagnosis could not be performed, the six patients who had endobronchial located tumour were assessed as radiologically tumour. There was no effect of the evaluated parameters on the cytologic results of the procedures. The examinations of the first and second SS samples were not superior to each other, whereas the diagnostic value of the second IS was better than the first one (p= 0.045). Besides, both samples of the IS had a higher diagnostic yield in the diagnosis of lung cancer than SS (p= 0.015 and p= 0.0005, respectively). IS and SS cytology can not take the place of FOB in the diagnosis of lung cancer. However, sputum induction could be used as a noninvasive method in patients in whom histological diagnosis is needed and fiberoptic bronchoscopy Is contraindicated.
Açıklama
Anahtar Kelimeler
Solunum Sistemi
Kaynak
Solunum Hastalıkları
WoS Q Değeri
Scopus Q Değeri
Cilt
13
Sayı
1
