title: Sputum cytology examination followed by autofluorescence bronchoscopy: a practical way of identifying early stage lung cancer in central airway.
abstract: 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.
authors.affiliation: University Department of Medicine, University of Hong Kong, China. lambing@hkucc.hku.hk
authors.forename: Bing
authors.initials: B
authors.lastname: Lam
authors.forename: Sui Y
authors.initials: SY
authors.lastname: Lam
authors.forename: Maria P
authors.initials: MP
authors.lastname: Wong
authors.forename: Clara G C
authors.initials: CG
authors.lastname: Ooi
authors.forename: Daniel Y T
authors.initials: DY
authors.lastname: Fong
authors.forename: David C L
authors.initials: DC
authors.lastname: Lam
authors.forename: Agnes Y K
authors.initials: AY
authors.lastname: Lai
authors.forename: Cheuk-Ming
authors.initials: CM
authors.lastname: Tam
authors.forename: Clara B Y
authors.initials: CB
authors.lastname: Pang
authors.forename: Mary S M
authors.initials: MS
authors.lastname: Ip
authors.forename: Wah-Kit
authors.initials: WK
authors.lastname: Lam
mesh_terms: 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*