A prospective analysis of touch preparation cytology for intraoperative detection of mediastinal lymph node metastases

Alison Wenholz, Xiao Meng Xu, Ranjana Nawgiri, Ikenna Okereke

Research output: Contribution to journalArticle

Abstract

Introduction: Patients diagnosed with lung cancer may require immediate evaluation of mediastinal lymph nodes to determine treatment plan. Typically, frozen section (FS) analysis has been used, but this analysis can be time-consuming and uses more tissue than touch preparation (TP) cytologic analysis. TP accuracy has been studied in other organs, but no prospective studies comparing TP to FS have been performed on mediastinal lymph nodes in lung cancer. Our goal was to compare the accuracy of TP to FS in these cases. Materials and methods: After obtaining institutional review board approval, all patients undergoing mediastinal lymph node evaluation for a diagnosis of lung cancer were asked to participate. If consent was given, TP and FS analyses were performed on all mediastinal lymph node stations in all patients and compared to permanent hematoxylin and eosin analysis. Data were collected prospectively. Results: Twenty patients were enrolled. Mean age was 67.7 years. Fifty-five percent (11 of 20) of patients were men. The mean number of lymph node stations sampled in each patient was 3.4. In predicting the stage of the patient, TP had a sensitivity and specificity of 95% and 100%, respectively. FS had a lower sensitivity, 85%, and a specificity of 100%. On permanent analysis, metastatic foci ranged in size from 0.15 mm to 1.5 mm. Conclusions: TP was more sensitive than FS in detecting mediastinal lymph node metastases. The technical difficulty of obtaining full-thickness sections without creating significant artifact may contribute to the lower sensitivity of FS in detecting micrometastases.

Original languageEnglish (US)
JournalJournal of the American Society of Cytopathology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Touch
Frozen Sections
Cell Biology
Lymph Nodes
Neoplasm Metastasis
Lung Neoplasms
Neoplasm Micrometastasis
Research Ethics Committees
Hematoxylin
Eosine Yellowish-(YS)
Artifacts
Prospective Studies
Sensitivity and Specificity

Keywords

  • Frozen section specimens
  • Lung cancer
  • Touch preparation cytology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

@article{db4ab8279bc34d25a34a90937893e0b7,
title = "A prospective analysis of touch preparation cytology for intraoperative detection of mediastinal lymph node metastases",
abstract = "Introduction: Patients diagnosed with lung cancer may require immediate evaluation of mediastinal lymph nodes to determine treatment plan. Typically, frozen section (FS) analysis has been used, but this analysis can be time-consuming and uses more tissue than touch preparation (TP) cytologic analysis. TP accuracy has been studied in other organs, but no prospective studies comparing TP to FS have been performed on mediastinal lymph nodes in lung cancer. Our goal was to compare the accuracy of TP to FS in these cases. Materials and methods: After obtaining institutional review board approval, all patients undergoing mediastinal lymph node evaluation for a diagnosis of lung cancer were asked to participate. If consent was given, TP and FS analyses were performed on all mediastinal lymph node stations in all patients and compared to permanent hematoxylin and eosin analysis. Data were collected prospectively. Results: Twenty patients were enrolled. Mean age was 67.7 years. Fifty-five percent (11 of 20) of patients were men. The mean number of lymph node stations sampled in each patient was 3.4. In predicting the stage of the patient, TP had a sensitivity and specificity of 95{\%} and 100{\%}, respectively. FS had a lower sensitivity, 85{\%}, and a specificity of 100{\%}. On permanent analysis, metastatic foci ranged in size from 0.15 mm to 1.5 mm. Conclusions: TP was more sensitive than FS in detecting mediastinal lymph node metastases. The technical difficulty of obtaining full-thickness sections without creating significant artifact may contribute to the lower sensitivity of FS in detecting micrometastases.",
keywords = "Frozen section specimens, Lung cancer, Touch preparation cytology",
author = "Alison Wenholz and Xu, {Xiao Meng} and Ranjana Nawgiri and Ikenna Okereke",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jasc.2018.12.001",
language = "English (US)",
journal = "Journal of the American Society of Cytopathology",
issn = "2213-2945",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - A prospective analysis of touch preparation cytology for intraoperative detection of mediastinal lymph node metastases

AU - Wenholz, Alison

AU - Xu, Xiao Meng

AU - Nawgiri, Ranjana

AU - Okereke, Ikenna

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Patients diagnosed with lung cancer may require immediate evaluation of mediastinal lymph nodes to determine treatment plan. Typically, frozen section (FS) analysis has been used, but this analysis can be time-consuming and uses more tissue than touch preparation (TP) cytologic analysis. TP accuracy has been studied in other organs, but no prospective studies comparing TP to FS have been performed on mediastinal lymph nodes in lung cancer. Our goal was to compare the accuracy of TP to FS in these cases. Materials and methods: After obtaining institutional review board approval, all patients undergoing mediastinal lymph node evaluation for a diagnosis of lung cancer were asked to participate. If consent was given, TP and FS analyses were performed on all mediastinal lymph node stations in all patients and compared to permanent hematoxylin and eosin analysis. Data were collected prospectively. Results: Twenty patients were enrolled. Mean age was 67.7 years. Fifty-five percent (11 of 20) of patients were men. The mean number of lymph node stations sampled in each patient was 3.4. In predicting the stage of the patient, TP had a sensitivity and specificity of 95% and 100%, respectively. FS had a lower sensitivity, 85%, and a specificity of 100%. On permanent analysis, metastatic foci ranged in size from 0.15 mm to 1.5 mm. Conclusions: TP was more sensitive than FS in detecting mediastinal lymph node metastases. The technical difficulty of obtaining full-thickness sections without creating significant artifact may contribute to the lower sensitivity of FS in detecting micrometastases.

AB - Introduction: Patients diagnosed with lung cancer may require immediate evaluation of mediastinal lymph nodes to determine treatment plan. Typically, frozen section (FS) analysis has been used, but this analysis can be time-consuming and uses more tissue than touch preparation (TP) cytologic analysis. TP accuracy has been studied in other organs, but no prospective studies comparing TP to FS have been performed on mediastinal lymph nodes in lung cancer. Our goal was to compare the accuracy of TP to FS in these cases. Materials and methods: After obtaining institutional review board approval, all patients undergoing mediastinal lymph node evaluation for a diagnosis of lung cancer were asked to participate. If consent was given, TP and FS analyses were performed on all mediastinal lymph node stations in all patients and compared to permanent hematoxylin and eosin analysis. Data were collected prospectively. Results: Twenty patients were enrolled. Mean age was 67.7 years. Fifty-five percent (11 of 20) of patients were men. The mean number of lymph node stations sampled in each patient was 3.4. In predicting the stage of the patient, TP had a sensitivity and specificity of 95% and 100%, respectively. FS had a lower sensitivity, 85%, and a specificity of 100%. On permanent analysis, metastatic foci ranged in size from 0.15 mm to 1.5 mm. Conclusions: TP was more sensitive than FS in detecting mediastinal lymph node metastases. The technical difficulty of obtaining full-thickness sections without creating significant artifact may contribute to the lower sensitivity of FS in detecting micrometastases.

KW - Frozen section specimens

KW - Lung cancer

KW - Touch preparation cytology

UR - http://www.scopus.com/inward/record.url?scp=85059169550&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059169550&partnerID=8YFLogxK

U2 - 10.1016/j.jasc.2018.12.001

DO - 10.1016/j.jasc.2018.12.001

M3 - Article

C2 - 31287424

AN - SCOPUS:85059169550

JO - Journal of the American Society of Cytopathology

JF - Journal of the American Society of Cytopathology

SN - 2213-2945

ER -