The Role of TTNA Cell Block for Pulmonary Lesions at Universitas Gadjah Mada Academic Hospital

Background: Lung cancer is the leading cause of cancer-related mortality worldwide, with a high incidence in Indonesia. Early diagnosis remains challenging and directly affects patient prognosis. Cell block cytology derived from Transthoracic Needle Aspiration (TTNA) provides a minimally invasive alternative enabling morphological, immunohistochemical, and molecular analyses. This study aimed to evaluate the role of TTNA cell blocks for pulmonary lesions at Universitas Gadjah Mada Academic Hospital.Method: A cross-sectional observational study was conducted at Universitas Gadjah Mada Academic Hospital using consecutive sampling. Subjects included patients with clinical pulmonary lesions who met the inclusion and exclusion criteria. Concordance between TTNA cell block and core biopsy was assessed based on qualitative and quantitative parameters using Cohen’s kappa and diagnostic test.Result: Twenty-two patients were enrolled, predominantly male, with a mean age of 63 years. Qualitative concordance between TTNA cell block and core biopsy yielded a Cohen’s kappa of 0.52 (p=0.002). Quantitative concordance yielded a Cohen’s kappa of -0.076 (p=0.460). The TTNA cell block demonstrated a sensitivity of 82%, specificity of 0%, positive predictive value of 100%, negative predictive value of 0%, and overall accuracy of 82%.Conclusion: The TTNA cell block examination exhibited excellent qualitative concordance with core biopsy, thereby enhancing its diagnostic role in cases of pulmonary lesions. However, given the low quantitative concordance, the TTNA cell block cannot serve as a substitute for core biopsy in the context of molecular testing for pulmonary lesions.