Fluorescence bronchoscopy in the detection of preinvasive bronchial lesions in patients with sputum cytology suspicious or positive for malignancy.
BACKGROUND
A new strategy in the treatment of squamous cell carcinoma of the tracheobronchial tree is the detection and eradication of preinvasive bronchial lesions before they become invasive cancers. It is, however, difficult to detect preinvasive lesions by conventional white-light bronchoscopy alone.


OBJECTIVE
we conducted a detailed investigation on the use of fluorescence bronchoscopy in the detection of preinvasive bronchial lesions in patients with sputum cytology suspicious or positive for malignancy.


METHODS
64 participants with sputum cytology suspicious or positive for malignancy were examined with both white light and fluorescence bronchoscopy (LIFE group). Earlier to this study, before fluorescence bronchoscopy became available in our institute, 48 participants having sputum cytology suspicious or positive for malignancy were examined with white light bronchoscopy alone (control group). Biopsy specimens for pathological examinations were taken of all abnormal areas discovered by white light or fluorescence bronchoscopy examination.


RESULTS
In sputum cytology suspicious or positive for malignancy, the diagnosis of preinvasive bronchial lesions was greatly enhanced in the LIFE group as compared with the control group (45 vs. 7 lesions). The percentage of participants with preinvasive bronchial lesions was also significantly higher in the LIFE group than in the control group (40.6 vs. 12.5%, P = 0.00087, respectively).


CONCLUSIONS
Our study suggests that the use of fluorescence bronchoscopy in addition to conventional white-light examination could greatly enhance the detection and localization of preinvasive bronchial lesions in patients with sputum cytology suspicious or positive for malignancy.
Department of Surgery, Institute of Pulmonary Cancer Research, Chiba University School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
K
K
Shibuya
T
T
Fujisawa
H
H
Hoshino
M
M
Baba
Y
Y
Saitoh
T
T
Iizasa
M
M
Suzuki
M
M
Otsuji
K
K
Hiroshima
H
H
Ohwada
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001999:Bronchoscopy / Q000379:methods*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003627:Data Interpretation, Statistical; D005260:Female; D005453:Fluorescence; D006801:Humans; D008027:Light; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D013183:Sputum / Q000166:cytology*