الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 113 |  |  |
| | | from | 113 | | |
Abstract
A cross-sectional observational research was conducted in the Department of Respiratory Medicine, Minia Cardiothoracic University Hospital, in partnership with the Department of Pathology, from November 2021 to November 2022. The study included 73 individuals who had a soft tissue mass detected on a CT chest scan. Patients were admitted after signing an informed consent form.
Patients were subjected to the following:
Complete medical history (age, gender, smoking status, any specific history such as TB and occupational history, and chest symptoms).
Examination, both general and specific.
Routine investigations:
• Pre-bronchoscopy laboratory testing (CBC, ESR, INR, PC, liver function tests, and renal function tests).
• Radiological exams (simple X-ray of the chest, CT chest to identify abnormal chest radiographs suggesting lung cancer).
• Sputum cytology (before and after bronchoscopy samples in sixty cases of bronchoscopic procedure and sputum sample in thirteen cases of CT guided biopsies).
This therapy was given to sixty people and includes biopsies, BAL, and Wash to identify any abnormalities in the bronchial tree for the diagnosis of lung cancer.
Thirteen individuals had CT guided biopsies done.
Histopathological examination of materials, BAL and wash, and immunohistochemical examination of 46 instances of lung cancer were all confirmed.
Our data suggest that sputum cytology was conducted in 73 cases, with 27 demonstrating malignancy. All malignant cases were confirmed with biopsies, either bronchoscopic or CT guided. Furthermore, sputum cytology showed that 46 individuals did not have lung cancer, but biopsy proved lung cancer in 19 cases. In comparison to broncoscopic and CT guided biopsy, sputum cytology has a sensitivity of 58.7% and a specificity of 100%. The Kappa test was used, and the result was 0.512, which shows reasonable agreement between the two tests, while the p value indicates great statistical significance (p0.001).
Furthermore, with ages ranging from 20 to 82 years, the bulk of the patients tested were in their fifth and sixth decades of life. Males constituted 75.3% of the cases, while females constituted 52%.
Squamous cell carcinoma was also detected in 28.5% of bronchoscpic biopsy cases and 30% of sputum cytology cases, as well as in 28.5% of BAL cases. Adenocarcinoma was found in 31.4%, 40%, and 42.8% of patients, respectively, utilizing bronchoscopic biopsy, sputum cytology, and BAL. In addition, the p-value suggests that there is a statistically significant difference in cancer type between bronchoscopic biopsy, sputum cytology, and BAL.
A Chi square test was also used to investigate the link between tumor location and size and positive sputum cytology. With positive sputum cytology, there was a non-significant p value of 0.7 between the central and peripheral tumor location groups (57.1% and 63.6%, respectively).
With a statistically significant p-value of 0.001, sputum cytology revealed malignancy in the majority of patients (81.4%) with tumor size 2 cm, whereas only 18.5% of cases with size 2 cm were positive.
To confirm malignancy and subtype carcinomas, immunohistochemistry using a panel of primary antibodies was performed. CD56 and P63 were found in squamous cell carcinomas, but not Ck7 or Ck20.
Adenocarcinomas exhibited CK7 expression, were negative for Ck20, and had TTF1, Napsin A expression. TTF1, CD56, and P63 were shown to be positive in small cell lung carcinomas but negative in CK7 and CK20. CD3, CD4, and Tdt assays were performed on lymphoma patients.