BACKGROUND: There has been limited correlation of hematoidin crystals (HC) in sputum with clinical and diagnostic characteristics, partly because they are difficult to recognize. The aim of this study was, therefore, to assess these relationships in a consecutive cohort of sputum samples from patients submitted to a cytology laboratory.
METHODS: Adequate sputum samples from 489 individuals were enrolled in this study. These were fixed in ethanol, stained by the Papanicolaou method and examined microscopically. The normality of the distribution of the continuous variable (age in years) was examined using the Shapiro–Wilk normality test. As the data were not normally distributed, Kendall rank correlation was used to correlate age with the presence of HC. The Pearson's Chi-square test was used to determine if the proportion of cases with the presence of HC was different among the categorical data variables. A univariate binary logistic regression was used to determine the variables most strongly associated with HC presence. The results include odds ratios, 95% confidence intervals, Wald χ² statistics, and corresponding P values, with statistical significance assumed at P ≤ 0.05. Analyses were performed using IBM SPSS Statistics 22.
RESULTS: The presence of HC in sputum was associated with increasing age (P < 0.01), current smoking (P < 0.001), chronic occupational exposure to dust (P = 0.001), and hemoptysis (P < 0.001). These crystals were most prevalent in patients with a diagnosis of carcinoma (93.9%), bronchiectasis (48%), silicosis (16.0%), and chronic obstructive pulmonary disease (0.8%). Crystals were not found in patients with acute bronchitis, asthma, or lung infections, including viral and bacterial pneumonia.
CONCLUSIONS: There are clear associations linked to the finding of HC in sputum that may be helpful in pointing to a specific diagnosis, such as the possibility of underlying carcinoma.


中文翻译：

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痰涂片中的类血凝素晶体：细胞病理学和临床关联。


背景：痰中的类血凝素晶体（HC）与临床和诊断特征之间的关联有限，部分原因是它们难以识别。因此，这项研究的目的是在连续队列的痰样本中评估这些关系，这些痰样本来自细胞学实验室。
方法：这项研究从489人身上采集了足够的痰液样本。将它们固定在乙醇中，通过帕潘尼古拉法染色，并进行显微镜检查。使用Shapiro-Wilk正态性检验检验了连续变量（年龄）的分布正态性。由于数据不是正态分布，因此使用肯德尔等级相关性将年龄与HC的存在相关联。皮尔逊卡方检验用于确定分类数据变量中是否存在HC的病例比例是否不同。使用单变量二元对数回归确定与HC存在最相关的变量。结果包括比值比，95％置信区间，沃尔德χ ^2组统计数据，以及相应的P值，具有统计学意义假设在P ≤0.05。使用IBM SPSS Statistics 22进行分析。
结果：痰中HC的存在与年龄增长（P <0.01），当前吸烟（P <0.001），长期职业性接触粉尘（P = 0.001）和咯血（P <0.001）有关。P <0.001）。这些晶体在诊断为癌症（93.9％），支气管扩张（48％），矽肺病（16.0％）和慢性阻塞性肺疾病（0.8％）的患者中最为普遍。在患有急性支气管炎，哮喘或肺部感染（包括病毒性和细菌性肺炎）的患者中未发现晶体。
结论： 与痰中HC的发现有明显的关联，可能有助于指出具体的诊断，例如潜在的癌变。