Efficacy of Bronchial Brushings and Trans-Bronchial Needle Aspiration in Diagnosing Carcinoma Lung

Bronchial brushing (BB) and the more recent trans-bronchial needle aspiration (TBNA) are well established techniques performed using flexible fiberoptic bronchoscope, for sampling trachobronchial lesions suspected of malignancy. Our aim was to assess the efficacy of these two techniques in diagnosing carcinoma lung, when used individually as well as in combination, taking bronchial biopsy as the "Gold Standard" diagnostic test. Of all the cases of suspected lung cancer received between 1 January 2003 to 30 September 2004, 181 cases were selected where flexible bronchoscopic samples of BB, TBNA as well as bronchial biopsy were taken. Samples were processed as per standard procedures of cytology and histology. Squamous cell carcinoma was the most common lung cancer followed by small cell type. Sensitivity of BB was 81.5%; while that of TBNA was 62.5%. Specificity of BB and TBNA was 77.8% and 66.7%, respectively. Efficacy of BB was better than TBNA in diagnosing lung cancers. Combined use of BB and TBNA showed better sensitivity and accuracy than either techniques used individually. Bronchial brushing is a superior technique in the diagnosis of lung cancers than TBNA. Their combined use can further improve the chances of early detection of lung cancers. Journal of Cytology 2007; 24 (1) : 46-50