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. 1971 Nov;26(6):623–631. doi: 10.1136/thx.26.6.623

The diagnosis of primary lung cancer with special reference to sputum cytology

N C Oswald 1,2, K F W Hinson 1,2, G Canti 1,2, A B Miller 1,2
PMCID: PMC472376  PMID: 5144641

Abstract

Of 2,545 in-patients with primary lung cancer, pathological proof of the diagnosis was obtained by sputum cytology in 48%, by bronchoscopy in 32%, by biopsy from miscellaneous sites in 12%, and at thoracotomy or necropsy only in 19%. The diagnosis was made solely on clinical and radiological evidence in 8%.

One or more satisfactory specimens of sputum from 2,035 patients gave a positivity rate of 59%. When three specimens of sputum were tested the positivity rate was 69% and when four or more were tested, 85%. The maximum false positivity rate was 0·7%. Agreement between the types of malignant cells found in the sputum and in resected or necropsy specimens occurred in 84%. The pathological diagnosis was based solely on sputum cytology in 40% of the patients in whom malignant cells were found in the sputum.

The total work of the sputum laboratories was analysed for one year (1967); sputum was examined from 1,598 patients, of whom 266 (17%) had positive results.

Of 1,518 patients who had a bronchoscopy, the positivity rate was 53%, and of 524 patients with biopsies from miscellaneous sites the rate was 64%.

Sputum cytology, as practised at present, is a very valuable method of diagnosis, but its demands on time and expertise make it unsuitable for general application outside large medical centres.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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