Abstract
Lung cancer is the most common cause of cancer-related deaths. A short survival rate often results from belated diagnosis made in advanced stages. Therapy individualization requires the collection of a viable material for histopathological examination, which often brings difficulties. This study was performed in a group of 110 patients suspected of malignancy in chest computed tomography. All subjects underwent bronchofiberoscopy. Bronchoalveolar lavage (BAL) and endobronchial brushing were performed in all cases, whereas forceps tissue biopsy was taken if mucous membrane abnormalities were observed. In case of a negative result of bronchofiberoscopy invasive methods were implemented. A malignant neoplasm was diagnosed in 106 cases. Overall, cancer cells (positive result) were found in 45 patients (42.0%) subjected to bronchofiberoscopy. Cytology was positive in 38 (35.8%) and histopathological examination in 30 (28.3%) specimens. Eleven samples of BAL (10.3%) were positive. Endobronchial brushing was more effective, with 27 positive samples (25.5%). Forceps tissue biopsy was performed in 33 cases with 90% sensitivity. The most frequent cancer subtype found was squamous cell carcinoma. No severe complications of bronchofiberoscopy were observed. We conclude that bronchofiberosocpy is a safe diagnostic procedure for lung lesions, but its sensitivity and specificity are low. Only when there are mucous macroscopic changes observed, a precise diagnosis is possible.
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References
Adamczyk M, Tomaszewski G, Naumczyk P, Kluczewska E, Walecki J (2013) Usefulness of computed tomography virtual bronchoscopy in the evaluation of bronchi divisions. Pol J Radiol 78(1):30–41
Beckles MA, Spiro SG, Colice GL, Rudd RM (2003) Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes. Chest 123(1 Suppl):97S–104S
Bezel P, Tischler V, Robinson C, Baumueller S, Bode-Lesniewska B, Kohler M, Freitag L, Franzen D (2016) Diagnostic value of bronchoalveolar lavage for diagnosis of suspected peripheral lung cancer. Clin Lung Cancer 17(5):e151–e156
Binesh F, Pirdehghan A, Mirjalili MR, Samet M, Majomerd ZA, Akhavan A (2015) Comparative assessment of the diagnostic value of transbronchial lung biopsy and bronchoalveolar lavage fluid cytology in lung cancer. Asian Pac J Cancer Prev 16(1):201–204
Dela Cruz CS, Tanoue LT, Matthay RA (2011) Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med 32(4):605–644
Eberhardt WE, De Ruysscher D, Weder W, Le Pechoux C, De Leyn P, Hoffmann H, Westeel V, Stahel R, Felip E, Peters S, Panel Members (2015) 2nd ESMO consensus conference on lung cancer: locally advanced stage III non-small-cell lung cancer. Ann Oncol 26(8):1573–1588
Fukusumi M, Ichinose Y, Arimoto Y, Takeoka S, Homma C, Matsuoka H, Mouri A, Hamamoto Y, Matsumoto J, Kamimura M (2016) Bronchoscopy for pulmonary peripheral lesions with virtual fluoroscopic preprocedural planning combined with EBUS-GS: a pilot study. J Bronchol Interv Pulmonol 23(2):92–97
Horeweg N, van der Aalst CM, Vliegenthart R, Zhao Y, Xie X, Scholten ET, Mali W, Thunnissen E, Weenink C, Groen HJ, Lammers JW, Nackaerts K, van Rosmalen J, Oudkerk M, de Koning HJ (2013) Volumetric computed tomography screening for lung cancer: three rounds of the NELSON trial. Eur Respir J 42(6):1659–1667
Jakubowska K, Naumnik W, Niklinska W, Chyczewska E (2015) Clinical significance of HMGB-1 and TGF-beta level in serum and balf of advanced non-small cell lung cancer. Adv Exp Med Biol 852:49–58
Khan KA, Nardelli P, Jaeger A, O’Shea C, Cantillon-Murphy P, Kennedy MP (2016) Navigational bronchoscopy for early lung cancer: a road to therapy. Adv Ther 33(4):580–596
Labbe C, Beaudoin S, Martel S, Delage A, Joubert P, Drapeau C, Provencher S (2015) Diagnostic yield of non-guided flexible bronchoscopy for peripheral pulmonary neoplasia. Thorac Cancer 6(4):517–523
Naumnik W, Naumnik B, Niklinska W, Ossolinska M, Chyczewska E (2016) Clinical implications of hepatocyte growth factor, interleukin-20, and interleukin-22 in serum and bronchoalveolar fluid of patients with non-small cell lung cancer. Adv Exp Med Biol 952:41–49
NICE (National Institute for Health and Care Excellence) (2011) Lung cancer: diagnosis and management. Clinical guideline (CG121). Available from http://www.nice.org.uk/guidance/CG121. Accessed 1 Sept 2016
NLSTRT (National Lung Screening Trial Research Team), Aberle DR, Berg CD, Black WC, Church TR, Fagerstrom RM, Galen B, Gareen IF, Gatsonis C, Goldin J, Gohagan JK, Hillman B, Jaffe C, Kramer BS, Lynch D, Marcus PM, Schnall M, Sullivan DC, Zylak CJ (2011) The National Lung Screening Trial: overview and study design. Radiology 258(1):243–253
Oliveira C, Saraiva A (2010) Comparative study between computed tomography and bronchoscopy in the diagnosis of lung cancer. Radiol Bras 43(4):229–235
Pastor MD, Nogal A, Molina-Pinelo S, Quintanal-Villalonga A, Melendez R, Ferrer I, Romero-Romero B, De-Miquel MJ, Lopez-Campos JL, Corral J, Garcia-Carbonero R, Carnero A, Paz-Ares L (2016) IL-11 and CCL-1: novel protein diagnostic biomarkers of lung adenocarcinoma in bronchoalveolar lavage fluid (BALF). J Thorac Oncol. doi:10.1016/j.jtho.2016.07.026
Salomaa ER, Sallinen S, Hiekkanen H, Liippo K (2005) Delays in the diagnosis and treatment of lung cancer. Chest 128(4):2282–2288
Siegel RL, Miller KD, Jemal A (2016) Cancer statistics. CA Cancer J Clin 66(1):7–30
Silvestri GA, Hoffman BJ, Bhutani MS, Hawer RH, Coppage L, Sanders-Ciette A, Reed CE (1996) Endoscopic ultrasound with fine-needle aspiration in the diagnosis and staging of lung cancer. Ann Thorac Surg 61(5):1441–1445
Szlubowski A, Kuzdzal J, Kolodziej M, Soja J, Pankowski J, Obrochta A, Kopinski P, Zielinski M (2009) Endobronchial ultrasound-guided needle aspiration in the non-small cell lung cancer staging. Eur J Cardiothorac Surg 35(2):332–335
Toyoda Y, Nakayama T, Kusunoki Y, Iso H, Suzuki T (2008) Sensitivity and specificity of lung cancer screening using chest low-dose computed tomography. Br J Cancer 98(10):1602–1607
Vansteenkiste J, De Ruysscher D, Eberhardt WE, Lim E, Senan S, Felip E, Peters S, ESMO Guidelines Working Group (2013) Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 24(Suppl 6):vi89–vi98
Verma A, Lim AY, Tai DY, Goh SK, Kor AC, Dokeu Basheer AA, Chopra A, Abisheganaden J (2015) Timeliness of diagnosing lung cancer: number of procedures and time needed to establish diagnosis: being right the first time. Medicine (Baltimore) 94(29):e1216
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Nahorecki, A., Postrzech-Adamczyk, K., Straszak, E., Szuba, A., Janczak, D., Chabowski, M. (2017). Effectiveness of Bronchofiberoscopy in Diagnosis of Lung Lesions. In: Pokorski, M. (eds) Respiratory System Diseases. Advances in Experimental Medicine and Biology(), vol 980. Springer, Cham. https://doi.org/10.1007/5584_2017_6
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DOI: https://doi.org/10.1007/5584_2017_6
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