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A Study of the Results of Sputum Cytology as a Special Health Examination  

Lee, Jun-Hoo (Department of Occupational &)
Chae, Chang-Ho (Environmental Medicine, Samsung Changwon Hospital, College of Medicine, Sungkyunkwan University)
Kim, Young-Wook (Department of Occupational &)
Son, Jun-Seok (Environmental Medicine, Samsung Changwon Hospital, College of Medicine, Sungkyunkwan University)
Kim, Ja-Hyeon (Department of Occupational &)
Park, Seung-Hyun (Environmental Medicine, Samsung Changwon Hospital, College of Medicine, Sungkyunkwan University)
Cho, Ho-Seong (Department of Occupational &)
Publication Information
Annals of Occupational and Environmental Medicine / v.23, no.2, 2011 , pp. 122-129 More about this Journal
Abstract
Objectives: This study aims investigate the results of sputum cytology, which began its test period from 2009 as a special health examination for individuals whose lungs have been exposed to carcinogens. Methods: 22,215 cases of sputum results were classified into six categories through Papanicolau classification. The sputum results were analyzed according to age, exposure degree to welding fumes and smoking status. Chi-square tests and logistic regression analysis were used to compare and analyze the associations between sputum results and smoking status, exposure degree and age classifications. Results: The number of class I cases was 20,784 with a frequency of (93.6%), class II had 1,076 cases (4.8%), class III had 69 cases (0.3%), and the inadequate class had 286 cases (1.3%) and there were no cases in class VI and V. Patients in class III received CT scans of their chest for further evaluation, but no cancer patients were found from that. There were 2.48 times (95% CI 1.12~5.53) more smokers than non-smokers in class III and 1.70 times (95% CI 1.43~2.02) more in class II. The number of ex-smokers was 2.46 times (95% CI 1.01~5.99) larger than the number of non-smokers in class III and 1.28 times (95% CI 1.03~1.60) larger than the number of non-smokers in class II. There were 1.54 times (95% CI 1.28~1.85) more patients from the mid-exposure group than the low exposure group in class II. There were 1.62 times (95% CI 1.31~1.99) more patients from the high-exposure group than the low-exposure group in class II. Conclusions: As a screening test for lung cancer, the usefulness of sputum cytology is limited. However, the precancerous cells (class II, class III) varied according to welding fume exposure degree and smoking status.
Keywords
Sputum; Cell biology; Lung neoplasms; Efficiency;
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1 John R. Balmes. Occupational Lung Diseases. In: Joseph LaDou (eds) Occupational and Environmental Medicine. 4rd ed. MacGraw-Hill Companies, Inc. United States of America. 2007. pp 310-33.
2 Boers JE, ten Velde GP, Thunnissen FB. P53 in squamous metaplasia: a marker for risk of respiratory tract carcinoma. Am J Respir Crit Care Med. 1996;153:411-6.   DOI   ScienceOn
3 Steenland K. Ten-year update on mortality among mild-steel welders. Scand J Work Environ Health 2002;28:163-7.   DOI   ScienceOn
4 Lerchen ML, Wiggins CL, Samet JM. Lung cancer and occupation in New Mexico. J Natl Cancer Inst 1987;79:639-45.
5 Beaumont JJ, Weiss NS. Lung cancer among welders. J Occup Med 1981;23:839-44.
6 Becker N, Claud J, Frentzel-beyme R. Cancer of arc welders exposed to fumes containing chromium and nickel. Scand J Work Environ Health 1985;11:75-82.   DOI   ScienceOn
7 Hull CJ, Doyle E, Peters JM, Garabrant DH, Berstein L, Preston-Martin S. Case-control study of lung cancer in Los Angeles county welders. Am J Ind Med 1989;16:103-12.   DOI   ScienceOn
8 Stern RM. Assessment of risk of lung cancer for welders. Arch Environ Health 1983;38:148-55.   DOI   ScienceOn
9 Moulin JJ. A meta-analysis of epidemiologic studies of lung cancer in welders. Scand J Work Environ Health 1997;23:104-13.   DOI   ScienceOn
10 Frost JK, Ball WC Jr, Levin ML, Tockman MS, Baker RR, Carter D, Eggleston JC, Erozan YS, Gupta PK, Khouri NF. Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. Am Rev Respir Dis 1984;130:549-54.
11 Flehinger BJ, Melamed MR, Zaman MB, Heelan RT, Perchick WB, Martini N. Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Memorial Sloan-Kettering study. Am Rev Respir Dis 1984;130:555-60.
12 Fontana RS, Sanderson DR, Taylor WF, Woolner LB, Miller WE, Muhm JR, Uhlenhopp MA. Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Mayo Clinic study. Am Rev Respir Dis 1984;130:561-5.
13 International Agency for Research on Cancer. GLOBOCAN 2008. Available:http://globocan.iarc.fr/ factsheets/populations/factsheet.asp?uno=900 [cited 11 December 2010].
14 National Cancer Information Center. 2008 year cancer statistics data (translated by Lee JH). Available:http://www.cancer.go.kr/cms/statics/mortality/index.html [cited 20 December 2010]. (Korean)
15 Statistics Korea. crude mortality rate (translated by Lee JH). Available:http://kosis.kr/gen_etl/start.jsp?orgId=101&tblId=DT_1B34E01&conn_path=I2&path [cited 20 December 2010]. (Korean)
16 National Cancer Information Center. 5 year survival rate of major cancer. 1993-2008 (translated by Lee JH). Availabe:http://www.cancer.go.kr/cms/statics/survival_rate/index.html [cited 20 December 2010]. (Korean)
17 Henschke Cl, McCauley DI, Yankelevitz DF, Naidich DP, McGuinness G, Miettinen OS, Libby D, Pasmantier M, Koizumi J, Altorki N, Smith JP. Early lung cancer action project: a summary of the findings on baseline screening. Oncologist 2001;6:147-52.   DOI   ScienceOn
18 Nawa T, Nakagawa T, Kusano S, Kawasaki Y, Sugawara Y, Nakata H. Lung cancer screening using low-dose spiral CT: results of baseline and 1-year follow-up studies. Chest. 2002;122:15-20.   DOI   ScienceOn
19 The International Early Lung Cancer Action Program Investigators (I-ELCAP), Henschke CI, Yankelevitz DF, Libby DM, Pasmantier MW, Smith JP, Miettinen OS. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006;355:1763-71.   DOI   ScienceOn
20 Foy M, Yip R, Chen X, Kimmel M, Gorlova OY, Henschke CL. Modeling the mortality reduction due to computed tomography screening for lung cancer. Cancer. 2011 Jan 10. [Epub ahead of print]
21 Kern WH. The diagnostic accuracy of sputum and urine cytology. Acta Cytol 1988;32:651-4.
22 Doria-Rose VP, Marcus PM, Szabo E, Tockman MS, Melamed MR, Prorok PC. Randomized controlled trials of the efficacy of lung cancer screening by sputum cytology revisited: a combined mortality analysis from the Johns Hopkins Lung Project and the Memorial Sloan-Kettering Lung Study. Cancer 2009;115:5007-17.   DOI   ScienceOn
23 Henschke CI, McCauley DI, Yankelevitz DF, Naidich DP, McGuinness G, Smith JP, Early lung cancer action project: overall design findings from baseline screening. Lancet 1999;354:99-105.   DOI   ScienceOn
24 Annual Report of National Cancer Registry(1983-2007) (translated by Lee JH). Available:http://ncc.re.kr/manage/manage03_033_view.jsp?bbsnum=150&hSelSearch=&hTxtKeyword=¤t_page=1&cd=null [cited 20 December 2010]. (Korean)
25 Ng AB, Horak GC. Factors significant in the diagnostic accuracy of lung cytology in bronchial washing and sputum samples. II. Sputum samples. Acta Cytol 1983;27:397-402.
26 Tanaka T, Yamamoto M, Tamura T, Moritani Y, Miyai M, Hiraki S, Ohnoshi T, Kimura I. Cytologic and histologic correlation in primary lung cancer. A study of 154 cases with resectable tumors. Acta Cytol 1985;29:49-56.
27 Gupta RK. Value of sputum cytology in the diagnosis and typing of broncogenic carcinomas, excluding adenocarcinomas. Acta Cytol 1982;26:645-8.
28 Pilotti S, Rilke F, Gribaudi G, Ravasi GL. Sputum cytology for the diagnosis of carcinoma of the lung. Acta Cytol 1982;26:649-54.
29 Oswald NC, Hinson KF, Canti G, Miller AB. The diagnosis of primary lung cancer with special reference to sputum cytology. Thorax 1971;26:623-7.   DOI   ScienceOn
30 Cho EY, Park HD, Kim SH, Park WS, Chae SW, Kim EJ, Sohn JH. Usefulness of sputum cytology as a diagnostic tool of lung cancer. Korean J Cytopathol 2004;15:75-80. (Korean)
31 Kim SH, Kim EK, Shi KD, Kim JH, Yoo JH, Kim KS, Kim JY, Kim GI, An HJ, Lee JH. A comparison of conventional cytology and ThinPrep cytology of bronchial washing fluid in the diagnosis of lung cancer. Tuberc Respir Dis 2007;62:523-530. (Korean)   DOI
32 Saccomanno G, Archer VE, Auerbach O, Saunders RP, Brennan LM. Development of carcinoma of the lung as reflected in exfoliated cells. Cancer 1974;33:256-70.   DOI   ScienceOn
33 Annual Report of National Cancer Registry(2007) (translated by Lee JH). Avail able: http://ncc.re.kr/manage/manage03_033_view.jsp?bbsnum=150&hSelSearch=&hTxtKeyword=¤t_page=1&cd= [cited 20 December 2010]. (Korean)