Researchers from the Mayo Clinic have reported that fluorescence in situ hybridization (FISH) is more accurate than cytology in detecting lung cancer in bronchoscopy specimens. Furthermore, the combination of tests is even more accurate. These results were published in the journal Chest.

In the U.S. and Europe, lung cancer is the leading cause of cancer deaths. Lung cancer is often detected at a late stage, when it is incurable. This has prompted interest in approaches to improve the early detection of lung cancer.

When lung abnormalities are detected by chest X-ray or computed tomography (CT) scan, patients may undergo a biopsy or bronchoscopy in order to determine whether cancer is present. A bronchoscopy involves the use of a flexible lighted tube to examine the lungs and airways.

During a bronchoscopy, samples of cells may be removed for further analysis. Two approaches to examining these cells are cytology and fluorescence in situ hybridization (FISH). Cytology involves the examination of cells under a microscope. FISH is a molecular technique that tests cells for chromosomal abnormalities.

To compare the accuracy of cytology and FISH, researchers conducted a study among 137 patients who underwent bronchoscopy because of suspected lung cancer. Cell samples were collected by “washing” or “brushing.”

  • Using brushing specimens, FISH detected 71% of lung cancers and cytology detected 51% of lung cancers.
  • Using washing specimens, FISH detected 49% of lung cancers and cytology detected 44% of lung cancers
  • Using brushing specimens, the combination of FISH and cytology detected 75% of lung cancers. Using washing specimens, the combination of FISH and cytology detected 61% of lung cancers.

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The researchers conclude that in bronchial brushing samples, FISH detects a higher proportion of lung cancers than cytology. Furthermore, the combination of FISH and cytology detects more lung cancers than cytology alone in both brushing and washing samples.

Reference: Halling KC, Rickman OB, Kipp BR, Harwood AR, Doerr CH, Jett JR. A Comparison of Cytology and Fluorescence in Situ Hybridization for the Detection of Lung Cancer in Bronchoscopic Specimens. Chest. 2006;130:694-701.

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