Fluorescence Bronchoscopy for Localizing Early Bronchial Cancer and Carcinoma in Situ

Abstract

The detection, diagnosis, and aggressive treatment of lung cancer in its intrabronchial or preinvasive phase has been shown to result in 5-year survival rates of over 70%–80% [16, 19, 29]. In the case of carcinoma in situ, resection may result in prolonged survival and possibly cure [4]. In contrast, stage I lung cancer is of the invasive type and includes lesions that have already extended to the ipsilateral hilar lymph nodes; the 5-year survival at this stage is at best about 40%–50%. In small peripheral lung cancers (less than 3.0 cm in diameter), visible on chest X-ray but without hilar lymph node involvement, 5-year survival can be up to 60% [18]. The goal of physicians, therefore, must be the diagnosis of preinvasive lung cancer in patients at high risk. High risk patients include heavy cigarette smokers who have smoked one package per day or more for 20 years or longer, particularly those over age 45 years. Patients at particularly high risk are heavy smokers who also have symptoms or signs related to lung cancer and especially include smokers who have also been occupationally exposed to asbestos, uranium mining, coke oven emissions, nickel, and chromates, which are known industrial carcinogens.