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Background/Aim. Lung cancer is one of the most common cancer types worldwide. More than 70% of patients are diagnosed with lung cancer in the advanced stages of the disease, with limited therapeutic options based on cytological and histopathological material. The value of cytology in diagnosing and subtyping non-small cell lung cancer (NSCLC) is very important for modern personalized therapies. The aim of this study was to find out the concordance between cytological and histopathological diagnosis of NSCLC and the accuracy, sensitivity, specificity, and the positive and negative predictive value of cytology in diagnosing lung cancer. Methods. A two-year retrospective study included 169 patients with cytological diagnosis of NSCLC, who, at the same time, had small biopsy and surgical specimens for histopathological diagnoses confirmation that were compared with cytological one. Histopathological diagnosis on surgical specimens was the golden standard for evaluation concordance to the cytological diagnosis of NSCLC and evaluation accuracy, specificity, sensitivity, and the positive and negative prognostic value of cytology as a diagnostic method for detecting lung cancer. Results. This study included 129 (76.3%) male and 40 (23.7%) female patients, aged between 39 and 83, with the average of 62.53 ± 7.6. There was no statistically significant difference between the ages of different genders (p = 0.207). The most frequent diagnosis among cytological diagnoses was NSCLC in 99 (58.58%) patients. Concordance between cytological and histopathological diagnoses of surgical specimens was 61.48%. There was no statistically significant difference between cytological diagnoses and histopathological diagnoses of small biopsies specimens (p = 0.856). The sensitivity, specificity, positive and negative prognostic value, and accuracy of cytology as a diagnostic method of lung cancer were 94.98%, 98.60%, 95.72%, 98.35%, and 97.71%, respectively. Conclusion. Cytological diagnosis of NSCLC is accurate, with high sensitivity, specificity, and benefits for patients. Most patients are diagnosed with advanced cancer when there is no surgical therapy option, and the only available diagnostic material is a small biopsy sampled during bronchoscopy. [ABSTRACT FROM AUTHOR]

Background/Aim. Small cell lung carcinoma (SCLC) is the most aggressive form of lung cancer. Patients with SCLC generally appear in a locally advanced or disseminated stage, when small biopsies and/or cytological materials are the only possibility for diagnosis. The aim of this study was to evaluate the validity of cytology in the initial diagnosis of SCLC, comparing cytological with histological findings of small biopsies. Methods. The retrospective study included 200 patients with cytological diagnosis of SCLC, established in the period from 2016 to 2018 based on examination of the exfoliative material (sputum), as well as abrasive and aspiration materials obtained during bronchoscopy. In the same act, bronchoscopic materials were taken for cytological and histological diagnosis. Cytological materials were stained by May Grünwald Giemsa and histological ones using hematoxylin-eosin and immunohistochemical stains. Results. The most frequently sampled materials were: transbronchial needle aspiration (TBNA) in 72.2% of the patients and bronchial brushing in 18.54% of the patients, in the following order: bronchial aspirate in 4.88%, tru-cut needle biopsy in 5.37%, and sputum in 2.44% of the patients. In 91.5% (183/200) of the patients cytological diagnosis of SCLC was histopathologically confirmed. Among 17 patients whose cytological diagnosis of SCLC was not confirmed histopathologically, another type of tumor was histopathologically proved for 12 (6%) of them: in 6 cases non SCLC not otherwise specified, and in each per one squamocellular carcinoma, adenocarcinoma, large cell carcinoma, mixed tumor (NSCLC with a neuroendocrine component), lymphoma and sarcoma. Finally, in five patients histological material was false-negative. Conclusion. Cytological diagnosis of SCLC is a reliable method which yields satisfactory accuracy. The best way is to be interpreted in conjunction with histology of small biopsies. When only cytological materials are available, in doubtful cases, other small round cell tumors, and poorly differentiated NSCLC, must be considered in the differential diagnosis. [ABSTRACT FROM AUTHOR]