Ortega-Carrillo C, Navarro-Reynoso F, Cicero-Sabido R

Language: Spanish
References: 12
Page: 369-373
PDF size: 81.16 Kb.

ABSTRACT

Fiberopticbronchoscopy (FOB) is a well established method for diagnosis in bronchogenic cancer (CABR). Objective: To evaluate sensitivity and specificity of FOB in suspicious cases of lung neoplasia. Material and methods: A total of 119 suspicious cases of CABR were subjected to FOB under local anesthesia with lidocaine and sedation and bronchial brushing and lavage were carried out. In all evident lesions, a biopsy was taken. Sputum was collected in carbowax for 5 days. When histopathogic and cytopathologic studies were negative, fine needle aspiration (FNA) of the lesion was performed; if pleural involvement was present, a biopsy and a sample of liquid were taken. Results: Of 119 cases, diagnosis of CABR was confirmed by FOB in 45: brushing 25; lavage 25, and biopsy 29 with sensitivity 52.33%, specificity 100%, PPV 100%, and NPV, 42.31%. In 17, positivity was obtained in two-thirds samples; in carbowax, three were positive. In another 41 CABR-suspicious cases, all FOB samples were negative and neoplasia was confirmed by FNA in 15, biopsy of extrathoracic lymphatic node in 11, pleural biopsy in eight and liquid cytopathology in six. Non-malignant pathology was found in 33 cases: pneumonia 22, lung abscess three and tuberculosis, eight. FBO is indicated in CABR-suspicious cases. Negativity of FOB samples is due to different causes. All FOB instruments must be in optimal operative conditions and must be handled by a well-trained endoscopist.

REFERENCES

1. Prakash UBS. Bronchoscopy. New York Raven Press; 1993.pp.1-6.

2. Colby TW, Koss MN, Travis WD. Atlas of tumor pathology. Tumors of the lower respiratory tract. Washington, D.C., USA: Army Forces Institute of Pathology; 1995.pp.91-97.

3. Alonso P, Cicero R. Biopsia por punción con aguja fina en patología torácica. In: Angeles A, Coordinator. Biopsia por punción con aguja fina. México, D.F.: INN Salvador Zubirán, Ángeles Editores; 1994.

4. Brandt HJ, Loddenkenper, Mai J. Atlas of diagnostic thoracoscopy. Stuttgart, Germany. George Thieme Verlag; 1985.pp.9-113.

5. Mendoza-Mendoza A, Ibarra-Galindo MA. Diagnóstico de cáncer pulmonar por fibrobroncoscopia y citología en lavado y cepillado bronquial. Neumol Cirug Torax (Mex) 1995;54:71-73.

6. 6 Lai S, Lee SS-J, Ting Y-M, Wang H-C, Lin CC, Lu J-Y. Diagnostic value of transbronchial lung biopsy under fluoroscopic guidance in solitary pulmonary nodule in an endemic area of tuberculosis. Respir Med 1996;90:139-143.

7. Prager D, Cameron R, Ford J, Fuglin RA. Bronchogenic carcinoma. In: Murray JF, Nadel JA, editors. Textbook of respiratory medicine. 3rd ed. Philadelphia, PA, USA: WB Saunders Co. 2000.pp.1419-1426.

8. Stringfield J, Markowitz DJ, Bentz, RR, Martin H, Welch MH, Weg JG. The effect of tumor size and location on diagnosis by fiberopticbronchoscopy. Chest 1977;72:474-476.

9. Mak VHF, Johnston A, Hetzel MR, Grubb CH. Value of washings and brushings at fiberopticbronchoscopy in the diagnosis of lung cancer. Thorax 1990;45:373-376.

10. Gaber KA, Goldman JM, Farrel DJ. Cytological examination of the whole endobronchial brush in bronchoscopic diagnosis of lung cancer. Respir Med 2002;96:259-261.

11. Romagnoli I, Vachier I, Vignola AM, Godard P, Bousquet J, Chanez P. Safety and cellular assessment of bronchial brushing airway diseases. Respir Med 1999;93:461-466.

12. Gellert AR, Rudd RM, Sinha G, Geddes DM. Fiberopticbronchoscopy: effect of multiple bronchial biopsies on diagnostic yield in bronchial carcinoma. Thorax 1982;37:684-687.