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Tytuł pozycji:

The value of bronchoalveolar lavage for discrimination between healthy and diseased individuals.

Tytuł:
The value of bronchoalveolar lavage for discrimination between healthy and diseased individuals.
Autorzy:
Frye BC; Department of Pneumology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Schupp JC; Department of Pneumology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.; Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA.
Rothe ME; Medical Hospital, Research Center Borstel, Sülfeld, Germany.
Köhler TC; Department of Pneumology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Prasse A; Department of Pneumology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.; Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.
Zissel G; Department of Pneumology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Vach W; Institute for Medical Biometry and Statistics, Center for Medical Biometry and Medical Informatics, Medical Center - University of Freiburg, Freiburg, Germany.
Müller-Quernheim J; Department of Pneumology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Źródło:
Journal of internal medicine [J Intern Med] 2020 Jan; Vol. 287 (1), pp. 54-65. Date of Electronic Publication: 2019 Oct 15.
Typ publikacji:
Comparative Study; Journal Article
Język:
English
Imprint Name(s):
Original Publication: Oxford : Blackwell Scientific Publications, c1989-
MeSH Terms:
Bronchoalveolar Lavage Fluid/*cytology
Lung Diseases/*diagnosis
Bronchoalveolar Lavage ; Cell Count ; Eosinophils/metabolism ; Female ; Humans ; Lymphocytes/metabolism ; Macrophages/metabolism ; Male ; Middle Aged ; Neutrophils/metabolism ; Reference Values ; Retrospective Studies ; Sensitivity and Specificity ; Smoking/adverse effects
References:
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Contributed Indexing:
Keywords: bronchoalveolar lavage; diagnostic accuracy; normal values
Entry Date(s):
Date Created: 20191016 Date Completed: 20200817 Latest Revision: 20200817
Update Code:
20240105
DOI:
10.1111/joim.12973
PMID:
31612575
Czasopismo naukowe
Background: Bronchoalveolar lavage (BAL) is standard diagnostic procedure. Procedural recommendations have been made by pneumological societies including normal values for interpretation of BAL cytology. These normal values derive from small studies in healthy volunteers and have never been analysed for their sensitivity and specificity.
Objectives: This study aims to analyse sensitivity and specificity of these normal values by assessing lavage cell composition in healthy and diseased individuals.
Methods: More than 6000 BAL were retrospectively analysed for their cellular distribution including BALs of 250 healthy individuals. All BALs were obtained under similar conditions.
Results: Bronchoalveolar lavage cytology of healthy individuals mirrors data from previous studies with smoking being the most important manipulator of BAL cytology. Analyses of proposed normal values demonstrate specificity between 80% and 95%, whereas sensitivity ranges between 35% and 65%. Using different mathematical models, a value summing up the differences to ATS-proposed normal values of the cytological pattern was found to best discriminate between healthy and diseased individuals with a sensitivity of nearly 60% with a predefined specificity of 95%.
Conclusion: In summary, our analysis confirmed prior results for healthy volunteers and enlarged these findings by analysing sensitivity and specificity of lavage results in an independent validation cohort of diseased individuals. Thereby, the study may influence the acceptance of BAL in the diagnostic workup of individuals with pulmonary diseases. Additionally, the study proposes a novel value that facilitates lavage interpretation and may therefore be useful in further studies.
(© 2019 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.)

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