Open AccessAutofluorescence bronchoscopy to identify pre-cancerous bronchial lesions
Author(s) -
Leonello Fuso,
Gabriella Pagliari,
Vincenzo Boniello,
A. Trovè,
Francesco Varone,
Antonio Longobardi,
Stefano M.M. Basso,
Lucio Trodella
Publication year - 2005
Publication title -
monaldi archives for chest disease. pulmonary series/monaldi archives for chest disease/monaldi archives for chest disease. cardiac series
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.196
H-Index - 46
eISSN - 2465-101X
pISSN - 1122-0643
DOI - 10.4081/monaldi.2005.628
Subject(s) - medicine , dysplasia , autofluorescence , bronchoscopy , biopsy , lung cancer , radiology , carcinoma in situ , pathology , carcinoma , physics , quantum mechanics , fluorescence
Background. This study aimed to assess the diagnostic yield of autofluorescence bronchoscopy (AFB) in the detection of pre-cancerous bronchial lesions in a non-selected sample of patients. Methods. Both fiberoptic white-light bronchoscopy (WLB) and AFB using the Storz D-light system were performed on 166 consecutive patients. Biopsy specimens were taken in areas of the tracheobronchial tree judged as abnormal or suspicious at WLB and/or AFB. The bronchoscopic procedures were randomly performed by two operators. Results. A total of 93 patients had a positive biopsy specimen: 80 for cancer and 13 for dysplasia. AFB was abnormal or suspicious in 85 of the 93 patients with a sensitivity of 91.4%. Specificity was 50.7%. In 16 patients with normal WLB examination, AFB identified abnormal or suspicious areas which had a positive biopsy. Thus AFB significantly improved sensitivity of WLB (100% vs 82.8%, respectively, p<0.001) in the entire sample of patients studied. Data was further analysed separately for patients with dysplasia and those with cancer. Indeed, 13 of 16 patients recognized only by AFB had a histological diagnosis of dysplasia. The remaining three patients had a diagnosis of cancer (small intraepithelial neoplastic lesions). Since no other patient with dysplasia was found, AFB had a sensitivity of 100% in diagnosing dysplasia. On the other hand, excluding the 13 patients with dysplasia, WLB had a high sensitivity in diagnosing cancer (93.7%). Conclusions. The AFB Storz system showed a high sensitivity. The increase in diagnostic yield of AFB in comparison with WLB was related to the power of AFB to identify pre-cancerous bronchial lesions so showing its usefulness in the early diagnosis of lung cancer.