J Korean Med Sci.  2006 Apr;21(2):242-246. 10.3346/jkms.2006.21.2.242.

Detection of Pre-invasive Endobronchial Tumors with D-light/Autofluorescence System

• Jang TW
• Oak CH
• Chun BK
• Jung MH

• KMID: 1781829
• DOI: http://doi.org/10.3346/jkms.2006.21.2.242

Abstract

Autofluorescence bronchoscopy (AFB) is one of the newly developed diagnostic tools to detect the pre-cancerous lesions in the bronchial tissue. The utility of DLight/AFB in the detection of pre-cancerous lesions was compared to the standard white light bronchoscopy (WLB). In 113 patients (male 106, female 7), who visited hospital for evaluation of lung cancer, WLB and AFB were done and 364 biopsy specimens were obtained from November 2001 to August 2002. The bronchoscopic findings on WLB and AFB were compared to the pathological findings. The pathologic diagnoses of the specimens were as follows: normal in 96; hyperplasia in 69; metaplasia in 32; mild dysplasia in 13, moderate dysplasia in 6, severe dysplasia in 4; carcinoma in situ in 6; invasive carcinoma in 57. The relative sensitivity of adjunctive AFB to WLB vs. WLB alone was 1.5 in moderate dysplasia or worse lesions, and 3.2 in intraepithelial neoplasia. The specificity of adjunctive AFB and WLB alone were 0.91 and 0.5, respectively. The adjunctive AFB to the standard WLB increased the detection rate of the localized pre-invasive lesions. However, there was high rate of false positive in AFB.

Keyword

Bronchoscopes; Fluorescence; Bronchoscopy; Lung Neoplasms

MeSH Terms

Precancerous Conditions/diagnosis/pathology
Middle Aged
Metaplasia
Male
Lung Neoplasms/diagnosis/pathology
Hyperplasia
Humans
Fluorescence
Female
Carcinoma, Squamous Cell/diagnosis/pathology
Carcinoma in Situ/diagnosis/pathology
Bronchoscopy/*methods
Bronchial Neoplasms/*diagnosis/pathology
Bronchi/pathology
Aged, 80 and over
Aged
Adult

Figure

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  Fig. 1 Normal fluorescence image.

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  Fig. 2 Abnormal fluorescence (A, C, and D) and white light bronchoscopic findings (B) of a 74 yr old male patient with carinoma in situ in left upper lobe bronchus, positive in sputum cytology, but roentgenographically occult lung cancer.

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  Fig. 3 Carcinoma in situ: full thickness change with cells showing cytologic features of squamous carcinoma (H & E, ×100).

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