Bronchial Brushing Increases the Diagnostic Yield of Fiberoptic Bronchoscopy in Bronchogenic Carcinoma
Abstract
Background: The importance of rapid and accurate cytopathological diagnosis in bronchial cancers is increasing due to advances in treatment modalities.
Aims: We evaluated the diagnostic methods and cytologic subtypes of bronchial cancers to determine the diagnostic reliability of different bronchoscopic techniques.
Material and methods: Retrospective data were obtained from the hospital files and pathological specimens of the patients with diagnosis of primary lung cancer from a period of 36 months. Cytological tumor typing was determined using histopathology of bronchoscopic forceps biopsy (FB), bronchial-bronchoalveolar lavage (BL), bronchial brushing (BB), transbronchial fine-needle biopsy. Computed tomography or ultrasonography guided transthoracic biopsy and surgical biopsies were used where the other interventional methods were inadequate for diagnosis.
Results: A total of 124 patients were diagnosed during study period. 119 (96%) of them were male. The median age was 68, ranging between 36 and 88 years. Histopathologic subtypes were determined as non-small cell carcinoma (NSCC) in 104 (83.9%), squamous cell carcinoma in 64 (51.6%), adenocarcinoma in 16 (12.9%), NSCC not otherwise specified in 24 (19.3%) and small cell carcinoma in 20 (16.1%) patients. The combination of FB, BL and BB established the diagnosis of bronchogenic carcinoma in most of the cases (92.6%).
Conclusions: Lung cancer is seen commonly in elderly male patients with smoking history and squamous cell carcinoma is the most common cytologic type. High diagnostic accuracy can be achieved by a combination of bronchoscopic FB, BB and BL procedures.
Keywords: Bronchoscopy; Lung cancer; Bronchial brushing
Full Text:
PDFReferences
Jones AM, Hanson IM, Armstrong GR, O'Driscoll BR. Value and accuracy of cytology in addition to histology in the diagnosis of lung cancer at flexible bronchoscopy. Respir Med. 2001;95(5):374-8
Mazzone P, Jain P, Arroliga AC, Matthay RA. Bronchoscopy and needle biopsy techniques for diagnosis and staging of lung cancer. Clin Chest Med. 2002;23(1):137-58, ix.
Schreiber G, McCrory DC. Performance characteristics of different modalities for diagnosis of suspected lung cancer: summary of published evidence. Chest. 2003;123(1 suppl):115S-128S.
Sing A, Freudenberg N, Kortsik C, Wertzel H, Klosa B, Hasse J. Comparison of the sensitivity of sputum and brush cytology in the diagnosis of lung carcinomas. Acta Cytol. 1997;41(2):399-408.
Jay SJ, Wehr K, Nicholson DP, Smith AL. Diagnostic sensitivity and specificity of pulmonary cytology: comparison of techniques used in conjunction with flexible fiber optic bronchoscopy. Acta Cytol. 1980;24(4):304-12.
Baaklini WA, Reinoso MA, Gorin AB, Sharafkaneh A, Manian P. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest. 2000;117(4):1049-54.
Lam WK, So SY, Hsu C, Yu DY. Fibreoptic bronchoscopy in the diagnosis of bronchial cancer: comparison of washings, brushings and biopsies in central and peripheral tumours. Clin Oncol. 1983;9(1):35-42.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 4.0 International License.
2013-2023 (CC-BY) Australian International Academic Centre PTY.LTD.
Advances in Bioscience and Clinical Medicine