Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Comparison of Thinprep (Liquid-Based Cytology) and Conventional Cytology : Abnormal Lesion on Bronchoscopy

기관기내시경상 이상병변을 보이는 환자에게 있어 Thinprep검사법과 기존세포검사법의 효율성 및 유용성에 대한 비교

  • Lee, Jung Ho (Department of Internal Medicine, College of Medicine, Konyang University) ;
  • Yang, Jung Kyung (Department of Internal Medicine, College of Medicine, Konyang University) ;
  • Jung, In Bum (Department of Internal Medicine, College of Medicine, Konyang University) ;
  • Lee, Jung Hea (Department of Pathology, College of Medicine, Konyang University) ;
  • Sul, Hae Jung (Department of Pathology, College of Medicine, Konyang University) ;
  • Kim, Yoon Mi (Department of Pathology, College of Medicine, Konyang University) ;
  • Kim, Bum Kyeng (Department of Pathology, College of Medicine, Konyang University) ;
  • Choi, Yue Jin (Department of Internal Medicine, College of Medicine, Konyang University) ;
  • Na, Moon Joon (Department of Internal Medicine, College of Medicine, Konyang University) ;
  • Son, Ji Woong (Department of Internal Medicine, College of Medicine, Konyang University)
  • 이정호 (건양대학교 의과대학 내과학교실) ;
  • 양정경 (건양대학교 의과대학 내과학교실) ;
  • 정인범 (건양대학교 의과대학 내과학교실) ;
  • 이정의 (건양대학교 의과대학 진단병리학교실) ;
  • 설혜정 (건양대학교 의과대학 진단병리학교실) ;
  • 김윤미 (건양대학교 의과대학 진단병리학교실) ;
  • 김범경 (건양대학교 의과대학 진단병리학교실) ;
  • 최유진 (건양대학교 의과대학 내과학교실) ;
  • 나문준 (건양대학교 의과대학 내과학교실) ;
  • 손지웅 (건양대학교 의과대학 내과학교실)
  • Received : 2006.10.26
  • Accepted : 2006.12.07
  • Published : 2006.12.30
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Abstract

Background: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. Methods: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. Results: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. Conclusions: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.

배 경: 액상 세포학 검사법(Liquid-based cytology)은 최근들어 각광을 받고있는 검사방법으로 여러 연구, 특히 산부인과적 영역에서 암진단에 높은 효율성을 보여주고 있다. 본 저자들은 기관지내시경상 이상병변을 보이는 환자에서 세척세포진, 솔질세포진, 액상 세포학 검사법인 Thinprep을 시행하여 진단율 및 효용성을 비교하여 보았다. 방법 및 대상: 본원에서 2005년 6월부터 9월까지 호흡기적 증상을 보여 내원한 환자 중 기관지내시경을 시행하여 병변이 발견된 30명의 환자에서 Thinprep과 기존세포검사를 시행하였다. 결 과: 이상병변을 보였던 30명의 환자 중 조직검사를 통해 암을 진단받은 환자는 24명이었으며 4명은 결핵, 각각 1명씩은 기관지확장증, 기관지-폐누공을 진단받았다. Thinprep에서 암인 24명의 환자 중 19명이, 기존세포검사에서 기관지솔질검사(brushing)을 통해 얻은 결과가 17명, 세척액(washing)은 12명에서 암세포나 비전형세포가 보였다. 두 방법 모두 암이 아닌 환자에서는 비전형세포는 보이지 않았다. 세척세포진검사는 민감도 50%, 특이도 100%, 양성예측도 100%, 음성예측도 33.3%, 솔질세포진검사는 민감도 70.8%, 특이도 100%, 양성예측도 100%, 음성예측도 46.2%, Thinprep에서는 민감도 79.2%, 특이도 100%, 양성예측도 100%, 음성예측도 54%를 보였다. 결 론: 액상 세포학 검사법인 Thinprep은 기존의 검사법보다 민감도, 음성예측도가 큰 검사로 폐암의 진단률을 높이는데 도움을 줄 수 있으며 앞으로 대단위의 연구가 필요할 것으로 생각된다.

Keywords

References

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