Early detection of bronchial lesions using newly developed videoendoscopy-based autofluorescence bronchoscopy.
The combination of white light and autofluorescence bronchoscopy has been reported to show better sensitivity in detecting dysplasia and cancer of the bronchus than white light alone. However, fiberoptic bronchoscopy has been replaced by videoendoscopy at most leading facilities for over a decade. To avoid interruption of the videoendoscopy examination to perform fiberscopy-based autofluorescence examination as well as enhancing the sensitivity of intraepithelial lesions, autofluorescence diagnosis system integrated into a videoendoscope (SAFE 3000, Pentax, Tokyo) was created. A total of 154 consecutive patients were studied using this system, containing 83 known or suspected lung cancer cases, 46 of the cases with abnormal sputum cytology findings, 10 follow up cases following lung cancer operations, and 15 heavy smokers with respiratory symptoms. Abnormal findings were recognized by white light and/or SAFE 3000 at 166 sites and biopsies were taken to evaluate the relationship between endoscopic findings and pathology results. The sensitivity of the system for CIS+dysplasia was 65% in white light and 90% in SAFE. This videoendoscopy-based autofluorescence system had significantly higher sensitivity for intraepithelial lesions than white light videoendoscopy alone.
Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan. ikeda@wd5.so-net.ne.jp
Norihiko
N
Ikeda
Hidetoshi
H
Honda
Aeru
A
Hayashi
Jitsuo
J
Usuda
Yasufumi
Y
Kato
Masahiro
M
Tsuboi
Tatsuo
T
Ohira
Takashi
T
Hirano
Harubumi
H
Kato
Hiromi
H
Serizawa
Yoshimitsu
Y
Aoki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000175:diagnosis*; D001999:Bronchoscopy / Q000379:methods*; D002278:Carcinoma in Situ / Q000175:diagnosis; D042241:Early Diagnosis; D005260:Female; D005453:Fluorescence; D006801:Humans; D008168:Lung / Q000166:cytology; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000175:diagnosis; D011230:Precancerous Conditions / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013183:Sputum / Q000166:cytology; D014741:Video Recording