Sputum cytology

Screening for lung cancer has used chest radiography (CR), low dose computed tomography (LDCT) and sputum cytology (SC). Estimates of the lead time (LT), i.e., the time interval from detection of lung cancer by screening to the development of symptoms, have been derived from longitudinal studies of populations at risk, tumor doubling time (DT), the ratio between its prevalence at the first round of screening and its annual incidence during follow-up, and by probability modeling derived from the results of screening trials.

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The technique of induced sputum has allowed to subdivide asthma patients into inflammatory phenotypes according to their level of granulocyte airway infiltration. There are very few studies which looked at detailed sputum and blood cell counts in a large cohort of asthmatics divided into inflammatory phenotypes.

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People concentrated in congregated systems, such as prisons, are important but often neglected reservoirs for TB transmission, and threaten those in the outside community. Therefore, this study was conducted to determine the prevalence of tuberculosis in a prison system of North Gondar Zone. Methods: An active case-finding survey in North Gondar Prison was carried out from March to May 2011. All prison inmates who had history of cough for at least a week were included in the study.

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Sputum Cytology: Sputum specimen can be obtained from the patient either spontaneously or by aerosol – induced method. Morning specimen resulting from overnight accumulation of secretion yields best results. Three to five consecutive days’ sputum samples should be examined to ensure maximum diagnostic accuracy. Fresh unfixed specimens are better than prefixed specimens in 70% ethyl alcohol or coating fixative such as carbowax or saccomano fixative.

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The advantages of diagnostic cytology are that it is a non-invasive, simple procedure, helps in faster reporting, is relatively inexpensive, has high population acceptance and facilitates cancer screening in the field. Diagnostic cytology can be carried out by different methods, which includes collection and examination of exfoliated cells such as vaginal scrapes, sputum, urine, body fluids etc. Collection of cells by brushing, scraping or abrasive techniques is usually employed to confirm or exclude malignancy.

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Diagnosis and Staging Screening Most patients with lung cancer present with advanced disease, raising the question of whether screening would detect these tumors at an earlier stage when they are theoretically more curable. The role of screening high-risk patients (for example current or former smokers 50 years of age) for early stage lung cancers is debated.

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Lung Cancer Chest x-ray and sputum cytology have been evaluated in randomized lung cancer screening trials. No reduction in lung cancer mortality has been seen, although all the controlled trials have had low statistical power. Even screening of high-risk subjects (smokers) has not proven beneficial. Spiral CT can diagnose lung cancers at early stages; however, false-positive rates are high. Spiral CT screening increases the number of lesions detected and increases the number of diagnostic and therapeutic procedures. However, its capacity to save lives is unproven.

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