Revista espanola de patologia : publicacion oficial de la Sociedad Espanola de Anatomia Patologica y de la Sociedad Espanola de Citologia · 2026
Diagnostic sensitivity: Surgical biopsy versus minimally invasive techniques in bronchopulmonary cancer.
СтатьяСравнительное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Ion-Andrei Denisa-Gabriela, Mocanu Elena, Chirila Sergiu, Muntean Catalina, Seicaru Liliana, Dantes Elena
Аннотация
INTRODUCTION AND OBJECTIVES: Lung cancer remains the leading cause of cancer-related mortality, with early diagnosis critical to prognosis and survival. Histopathological confirmation is achieved through invasive or minimally invasive methods, the effectiveness of which varies according to clinical context. This study aimed to assess the diagnostic sensitivity of procedures commonly used in the evaluation of suspected bronchopulmonary neoplasms.
MATERIALS AND METHODS: We conducted a retrospective study of 210 patients hospitalised in two specialised centres in southeastern Romania between 2023 and 2024, all presenting with clinical and imaging findings suggestive of bronchopulmonary cancer. We analysed the diagnostic results of endobronchial biopsy, bronchial aspirate cytology, pleural fluid cytology, and surgical biopsy. Sensitivity was calculated against confirmed histopathological diagnoses and compared using the McNemar test.
RESULTS: Surgical biopsy demonstrated the highest diagnostic performance (100% sensitivity), particularly in peripheral tumours or when minimally invasive procedures yielded inconclusive results. Endobronchial biopsy had a sensitivity of 80.2%, bronchial aspirate cytology 55.2%, and pleural fluid cytology 24.5% among patients with pleural effusion. While centrally located lesions were often accessible via bronchoscopy, minimally invasive methods were frequently insufficient when used alone. However, combining these approaches enhanced overall sensitivity in selected cases.
CONCLUSIONS: Surgical biopsy remains the gold standard for the definitive diagnosis of bronchopulmonary cancer. A stepwise diagnostic approach-starting with minimally invasive procedures and progressing to surgical biopsy when necessary-provides an optimal balance between diagnostic accuracy and patient safety. These findings underscore the importance of tailoring diagnostic strategies according to lesion location, resource availability, and individual clinical scenarios.
MATERIALS AND METHODS: We conducted a retrospective study of 210 patients hospitalised in two specialised centres in southeastern Romania between 2023 and 2024, all presenting with clinical and imaging findings suggestive of bronchopulmonary cancer. We analysed the diagnostic results of endobronchial biopsy, bronchial aspirate cytology, pleural fluid cytology, and surgical biopsy. Sensitivity was calculated against confirmed histopathological diagnoses and compared using the McNemar test.
RESULTS: Surgical biopsy demonstrated the highest diagnostic performance (100% sensitivity), particularly in peripheral tumours or when minimally invasive procedures yielded inconclusive results. Endobronchial biopsy had a sensitivity of 80.2%, bronchial aspirate cytology 55.2%, and pleural fluid cytology 24.5% among patients with pleural effusion. While centrally located lesions were often accessible via bronchoscopy, minimally invasive methods were frequently insufficient when used alone. However, combining these approaches enhanced overall sensitivity in selected cases.
CONCLUSIONS: Surgical biopsy remains the gold standard for the definitive diagnosis of bronchopulmonary cancer. A stepwise diagnostic approach-starting with minimally invasive procedures and progressing to surgical biopsy when necessary-provides an optimal balance between diagnostic accuracy and patient safety. These findings underscore the importance of tailoring diagnostic strategies according to lesion location, resource availability, and individual clinical scenarios.