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Abstract：
Background Liquid-based cytology (LBC) has shown advantages over conventional smears (CS), but previous applications in bronchoalveolar lavage (BAL) fluid have produced inconsistent results. This study compared LBC and CS for diagnosing lung cancer using BAL fluid. Methodology A prospective study was conducted on 92 patients suspected of having lung cancer. All patients underwent bronchoscopy and had a final diagnosis confirmed by histopathology of lesions tissue through biopsy. The study aimed to assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the two cytological methods, in a pair-wise fashion. In addition, the study evaluated the correlation of factors, such as the volume of fluid used in LBC and bronchoscopy lesion morphology, with the sensitivity of LBC. Results The study involved 78 participants who were diagnosed with lung cancer. The sensitivity, specificity, PPV, and NPV of LBC were 25.7%, 100%, 100%, and 19.4%, respectively, whereas those of CS were 15.4%, 85.7%, 85.7%, and 15.4%, respectively. Although the sensitivity of LBC was higher than that of CS, the difference was not statistically significant (p=0.096, McNemar test). Furthermore, the median fluid volume performed during LBC in patients with positive results was significantly higher than in those with negative results (p=0.001, Mann-Whitney U test). Conclusions The application of LBC to BAL fluid has demonstrated similar and potentially superior diagnostic accuracy compared to CS in detecting lung cancer. It is recommended that further investigation be undertaken to examine the relationship between the volume of fluid utilized during the LBC process and its diagnostic accuracy to enhance its sensitivity.
摘要：
背景技术液基细胞学(LBC)已显示优于常规涂片(CS),但是以前在支气管肺泡灌洗（BAL）液中的应用产生了不一致的结果。这项研究比较了使用BAL液诊断肺癌的LBC和CS。方法对92例怀疑患有肺癌的患者进行前瞻性研究。所有患者均接受支气管镜检查，并通过活检对病变组织进行组织病理学证实了最终诊断。这项研究旨在评估敏感性，特异性，阳性预测值(PPV)，两种细胞学方法的阴性预测值(NPV)，以成对的方式。此外,这项研究评估了因素之间的相关性，如LBC和支气管镜检查病变形态中使用的液体量，与LBC的敏感性。结果该研究涉及78名被诊断为肺癌的参与者。敏感性,特异性，PPV,LBC的NPV为25.7%，100%,100%,和19.4%，分别,而CS为15.4%，85.7%,85.7%,和15.4%，分别。尽管LBC的敏感性高于CS，差异无统计学意义(p=0.096,McNemar检验)。此外，结果阳性的患者在LBC期间的中位液体量显著高于结果阴性的患者(p=0.001,Mann-WhitneyU检验).结论与CS相比，LBC应用于BAL液在检测肺癌方面已显示出相似且可能优于CS的诊断准确性。建议进行进一步研究，以检查LBC过程中使用的流体体积与其诊断准确性之间的关系，以提高其灵敏度。
