Sputum cytology examination followed by autofluorescence bronchoscopy: a practical way of identifying early stage lung cancer in central airway.
BACKGROUND
The prognosis of early stage lung cancer was superior to that of late stages. We hypothesize that by using sputum cytology as the first screening method followed by autofluorescence bronchoscopy could detect early stage lung cancer in the central airway.


METHODS
During 18-month recruitment period, subjects at high risk for lung cancer (ever smoker accumulated more than 20 pack-year and above 40 years) followed up at Chest Clinics were invited to submit sputum for cytological examination. Subjects with sputum atypia were invited to have bronchoscopy, and CT thorax. After a mean follow-up of 39+/-14 months, the characteristics of lung cancers detected in the group with sputum atypia and the group with normal sputum at baseline were assessed.


RESULTS
181 subjects submitted sputum and primary lung cancer were diagnosed in 13. 46.2% of the lung cancers were in early stages. Bronchoscopy were performed in 85, and seven were confirmed to have lung cancer (six were in early stages). 81 had CT done and 92.6% had radiological abnormalities, though three lung cancers (all stage 0) were missed by CT. Five more primary lung cancers were diagnosed during the follow-up period: one in sputum atypia group and the other four (three were advanced adenocarcinoma) in normal sputum group. The overall sensitivity of sputum cytology in detecting lung cancer was 71.4% for all histology and 100% for squamous cell lung cancer.


CONCLUSIONS
Sputum cytology examination followed by bronchoscopy was a practical way of detecting early stage lung cancer in central airway.
Lam
Bing
B
University Department of Medicine, University of Hong Kong, China. lambing@hkucc.hku.hk
Lam
Sui Y
SY
Wong
Maria P
MP
Ooi
Clara G C
CG
Fong
Daniel Y T
DY
Lam
David C L
DC
Lai
Agnes Y K
AY
Tam
Cheuk-Ming
CM
Pang
Clara B Y
CB
Ip
Mary S M
MS
Lam
Wah-Kit
WK
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D003584:Cytological Techniques; D042241:Early Diagnosis; D005260:Female; D005453:Fluorescence; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D012307:Risk Factors; D012907:Smoking; D013183:Sputum / Q000166:cytology*