[Cell type agreement between bronchoscopic biopsy and thoracotomy specimens in primary lung cancer]

The aim of this study was to evaluate the diagnostic accuracy of bronchial biopsy specimens in establishing the specific cell type in primary lung cancer and to study the influence of several factors on this accuracy. 127 patients with lung cancer diagnosed by bronchoscopic biopsy specimens who subsequently underwent thoracotomy between April 2003 and December 2005 were included. There was cell agreement was between bronchoscopic biopsy and thoracotomy in 114 (89.8%) cases. The cell agreement was 92.5% in cases with squamous cell carcinoma and 42.8% in cases with adenocarcinoma (p= 0.002). Stage of the tumor, localization and morphology of the lesion had no effect on cell type agreement (p> 0.05). Cell type agreement in lesions without necrosis was higher (p= 0.09). Cell type agreement was 100% in well differentiated tumors, 94% in moderate differentiated tumors and 66.7% in poor differentiated tumors (p= 0.001). Similar results was demonstrated by the diameter of the tumor (p= 0.008); the smaller the diameter, the greater the cell agreement. In conclusion, cancer-cell type designation from bronchoscopic biopsy specimens is not without erroneous. The degree of cell differentiation is the most important factor affecting cell agreement.