Comparison of the autofluorescence bronchoscope and the white light bronchoscope in airway examination.
OBJECTIVE
The sensitivity and accuracy of white light bronchoscopy (WLB) in airway examination are low. Autofluorescence bronchoscope (AFB) can determine early lesions in bronchial mucosa more sensitively, but it has seldom performed in China. To assess the clinical value of the AFB in airway examination, we compared the sensitivity and specificity of the AFB and WLB in detecting cancer of the airway mucosa.


METHODS
Between September 2009 and May 2010, bronchoscope examinations using both the AFB and WLB were performed on 136 patients, 95 men and 41 women with a median age of 61.5 years (ranged from 25 to 84 years). There were 46 lesions located in the central airway, 84 in the peripheral lung parenchyma, and 6 in the mediastinal region. All patients received local and general anesthesia and were subsequently examined with the WLB and AFB in tandem. All procedures were completed safely. Abnormal visual findings were recorded, and biopsies of the affected regions were collected for pathologic examination.


RESULTS
Of 241 regions sampled for biopsy, 76 sites contained malignant lesions, whereas 165 sites contained benign lesions. The AFB detected 72 of the 76 malignant lesions, but the WLB detected only 50. The sensitivities of the AFB and WLB were 94.7% and 65.8%, respectively, and the specificities were 57.0% and 83.6%, respectively. The negative predictive values of the AFB and WLB were 95.9% and 84.1%, respectively.


CONCLUSIONS
The AFB is more sensitive than the WLB in detecting cancerous lesions in the mucosa, and is an effective airway examination.
Department of Thoracic Surgery, People's Hospital, Peking University, Beijing 100044, P. R. China.
Yun
Y
Li
Xiao
X
Li
Xi-Zhao
XZ
Sui
Liang
L
Bu
Zu-Li
ZL
Zhou
Fan
F
Yang
Yan-Guo
YG
Liu
Hui
H
Zhao
Jian-Feng
JF
Li
Jun
J
Liu
Guan-Chao
GC
Jiang
Jun
J
Wang
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001999:Bronchoscopy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D005260:Female; D006099:Granuloma / Q000175:diagnosis; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D008171:Lung Diseases / Q000175:diagnosis; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis