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Preinvasive Bronchial Lesions*: Surveillance or Intervention?

Anindo K. Banerjee, MRCP; Pamela H. Rabbitts, PhD; P. Jeremy George, FRCP
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*From the Molecular Oncology Group (Drs. Banerjee and Rabbitts), Department of Oncology, University of Cambridge, Cambridge, UK; and the Department of Thoracic Medicine (Dr. George), University College London Hospitals National Health Service Trust, London, UK.

Correspondence to: P. Jeremy George, Consultant Physician, Department of Thoracic Medicine, University College London Hospitals NHS Trust, Mortimer St, London W1T 3AA, UK; e-mail jeremy.george@uclh.org



Chest. 2004;125(5_suppl):95S-96S. doi:10.1378/chest.125.5_suppl.95S
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Preinvasive lesions are prevalent in the bronchial epithelium of smokers and are believed to be precursors of squamous cell carcinoma.1 These lesions are not easily detected with standard white light bronchoscopy, and so their natural history remains incompletely understood. However, their detection has been enhanced significantly over the past decade with the development of fluorescence bronchoscopy.2 We are undertaking a detailed longitudinal study of patients with preinvasive bronchial epithelial lesions in order to define their natural history. In contrast to the practice of most other centers,3 we have elected to keep lesions of all grades of severity under surveillance, including carcinoma in situ, but to intervene at the earliest signs of progression to invasive disease.

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