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Abstract
Objective
Patients with lung cancer have a relative high risk of developing secondary primary lung cancers. This study examined the additional value of autofluorescence bronchoscopy (AFB) for diagnosing synchronous lung cancers and premalignant lesions.
Methods
Patients diagnosed with lung cancer from January 2005 to December 2005 were enrolled in this study. The patients underwent a lung cancer evaluation, which included white light bronchoscopy (WLB), followed by AFB. In addition to the primary lesions, any abnormal or suspicious lesions detected during WLB and AFB were biopsied.
Results
Seventy-six patients had non-small cell lung cancer (NSCLC) and 23 had small cell lung cancer (SCLC). In addition to the primary lesions, 84 endobronchial biopsies were performed in 46 patients. Five definite synchronous cancerous lesions were detected in three patients with initial unresectable NSCLC and in one with SCLC. The secondary malignant lesions found in two patients were considered metastatic because of the presence of mediastinal nodes or systemic involvement. One patient with an unresectable NSCLC, two with a resectable NSCLC, and one with SCLC had severe dysplasia. The detection rate for cancerous lesions by the clinician was 6.0% (6/99) including AFB compared with 3.0% (3/99) with WLB alone. The prevalence of definite synchronized cancer was 4.0% (4/99) after using AFB compared with 2.0% (2/99) before, and the staging-up effect was 1.0% (1/99) after AFB. Since the majority of patients were diagnosed with advanced disease, the subjects with newly detected cancerous lesions did not have their treatment plans altered, except for one patient with a stage-up IV NSCLC who did not undergo radiotherapy.
Figures and Tables
Table 3
Pathologic findings of biopsied endobronchial lesions (n=84) in relation to WLB and AFB findings in 46 patients
Table 4
Clinical manifestations of patients with secondary severe dysplasia
Ade = adenocarcinoma, BRAA = biopsy result of abnormal autofluorescence, ES = extensive stage, LLL = left lower lobe, LMB = left main bronchus, LUL = left upper lobe, NSM = non-suspicious malignancy, RLL = right lower lobe, RML = right middle lobe, RUL = right upper lobe, SCC = small cell carcinoma, Squ = squamous cell carcinoma, WBF = white light bronchoscopic finding.
Table 5
Clinical manifestations of patients with secondary cancerous lesions
SM = suspicious malignancy, Ade = adenocarcinoma, BRAA = biopsy result of abnormal autofluorescence, CIS = carcinoma in situ, CSBA = clinical staging before autofluorescence bronchoscpy, ES = extensive stage, LLL = left lower lobe, LMB = left main bronchus, LS = limited stage, LUL = left upper lobe, NSM = non-suspicious malignancy, PM = primary mass, RLL = right lower lobe, RML = right middle lobe, RUL = right upper lobe, SCC = small cell carcinoma, Squ = squamous cell carcinoma, WBF = white light bronchoscopic finding.
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