Comparative Evaluation of Conventional Cytology, Liquid-Based Cytology and Cell Block Technique for Cytopathological Analysis of Pleural Aspirates

Comparative evaluation of cytological methods

  • Chinyelu Uchenna Ufoaroh Department of Internal Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka
  • Felix Emeka Menkiti Nnamdi Azikiwe University, Awka, Anambra State
  • Tobechukwu Nduaguba 4. Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi.
  • Somadina B Umeano Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi.
  • Shirley Nneka Chukwurah Department of Internal Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka
  • Chinedu Onwuka Ndukwe Department of Anatomic Pathology and Forensic Medicine, Faculty of Basic Clinical Sciences, Nnamdi Azikiwe University, Awka
  • Emeka H Enemuo Department of Internal Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka
  • Sunday P Aneke Department of Internal Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka
  • Prof. Department of Histopathology, Faculty of Basic Clinical Sciences, Chukwuemeka Odumegwu Ojukwu University, Awka.
  • Frank Chinedu Akpuaka Department of Surgery, Chukwuemeka Odumegwu Ojukwu University, Awka.
  • Victor Ahoma Mbanuzuru Department of Community Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka
Keywords: Pleural effusion, cytopathology, cell block, pleural effusion, diagnostic performance

Abstract

Objective: To compare the diagnostic accuracy, practicality, and utility of conventional cytology (CC), liquid-based cytology (LBC), and cell block (CB) techniques in the cytopathological evaluation of pleural aspirates, aiming to determine the most effective method for diagnosing pleural effusion (PE), particularly in distinguishing between benign and malignant conditions.

Methods: A cross-sectional descriptive study involving sixty-eight patients aged over 18 years with non-traumatic pleural effusion confirmed by clinical evaluation and chest X-ray was conducted at Nnamdi Azikiwe University Teaching Hospital from January 31, 2020, to January 31, 2022. Pleural fluid samples were processed using three cytological techniques: CC, LBC, and CB. The slides were evaluated and categorized into five diagnostic categories: non-diagnostic, negative for malignancy, atypia of undetermined significance, suspicious for malignancy, and malignant. Statistical analysis was performed using SPSS version 22.

Results: The study included 40 males (58.8%) and 28 females (41.2%), with a mean age of 51.6 ± 17.12 years. Malignant effusions were observed in 23 patients (33.8%). The CB technique demonstrated superior performance with a sensitivity of 82.6%, specificity of 88.9%, and an accuracy of 1. In contrast, LBC showed a sensitivity of 65.2% and specificity of 55.6%, while CC had the lowest sensitivity (17.4%) and specificity (51.1%). The CB method also achieved the highest negative predictive value (NPV = 1), outperforming LBC (NPV = 0.956) and CC (NPV = 0.852).

Conclusion: The CB technique was found to be the most reliable method for the cytopathological evaluation of pleural aspirates, exhibiting the highest sensitivity, specificity, and diagnostic accuracy. The study highlights the importance of selecting advanced cytological methods such as CB to enhance diagnostic precision in clinical practice, particularly in the differentiation of malignant from benign pleural effusions.

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CITATION
DOI: 10.26838/MEDRECH.2024.11.6.735
Published: 2024-11-13
How to Cite
1.
Ufoaroh CU, Menkiti FE, Nduaguba T, Umeano SB, Chukwurah SN, Ndukwe CO, Enemuo EH, Aneke SP, Okani CO, Akpuaka FC, Mbanuzuru VA. Comparative Evaluation of Conventional Cytology, Liquid-Based Cytology and Cell Block Technique for Cytopathological Analysis of Pleural Aspirates : Comparative evaluation of cytological methods. Med. res. chronicles [Internet]. 2024Nov.13 [cited 2024Dec.4];11(6):198-07. Available from: https://medrech.com/index.php/medrech/article/view/723
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Original Research Article