title: Value of cytologic analysis of bronchial washings in lung cancer on the basis of bronchoscopic appearance.
abstract: BACKGROUND
  We evaluated the diagnostic yield of cytologic analysis of bronchial washing in addition to forceps biopsy on the basis of bronchoscopic appearance and histologic type in lung cancer.
  
  
  METHODS
  This retrospective study included 611 patients who had lung cancer and underwent bronchoscopic procedures between April 2003 and December 2008. Bronchoscopic appearance was classified into six types (tumor, infiltrative, necrotic, normal, compressive and aspecific) on the basis of endoscopic morphology.
  
  
  RESULTS
  The forceps biopsy were positive in 492 cases (80.5%), and the diagnostic yield of the combination of forceps biopsy with cytologic analysis of bronchial washing was 84.1% (514/611 cases), that is, a statistically significant increase of 3.6% (P < 0.001). Washing cytologic analysis in the case of tumor, infiltrative and necrotic lesions had higher diagnostic yields than that in the case of normal, compressive and aspecific lesions (41.7% vs 29.3%), but its diagnostic yield did not increase on combination with forceps biopsy (P > 0.05). However, in the case of normal and compressive lesions, the addition of forceps biopsy to washing cytologic analysis significantly increased the diagnostic yield (P < 0.05). The histologic type of lung cancer did not significantly affect the difference in diagnostic yield between forceps biopsy alone and the combination of forceps biopsy and washing cytologic analysis (P > 0.05).
  
  
  CONCLUSIONS
  The combination of forceps biopsy and washing cytologic analysis offers a better diagnostic yield than biopsy alone in diagnosing lung cancer. Both procedures should be performed during bronchoscopy even if no endobronchial lesion is present.
authors.affiliation: Department of Internal Medicine, Konkuk University Chungju Hospital, Chungju, Korea.
authors.forename: Gi Dong
authors.initials: GD
authors.lastname: Lee
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: You Eun
authors.initials: YE
authors.lastname: Kim
authors.forename: Seung Jun
authors.initials: SJ
authors.lastname: Lee
authors.forename: Yu Ji
authors.initials: YJ
authors.lastname: Cho
authors.forename: Yi Yeong
authors.initials: YY
authors.lastname: Jeong
authors.forename: Kyoung-Nyeo
authors.initials: KN
authors.lastname: Jeon
authors.forename: In Seok
authors.initials: IS
authors.lastname: Jang
authors.forename: Jong Deok
authors.initials: JD
authors.lastname: Lee
authors.forename: Young Sil
authors.initials: YS
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D018893:Bronchoalveolar Lavage / Q000379:methods*; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods