Autofluorescence bronchoscopy (AFB) is an established method for detection of pre-/early malignant lesions. Many studies have shown an increased detection rate in risk groups when autofluorescence was combined with white light bronchoscopy (WLB). The aim of this study is to determine whether the routine application of AFB in the pre-operative diagnostic of lung cancer gives relevant additional information regarding further therapy especially about anatomic operability or synchronous existence of pre-/early malignant changes.
Since 2002 every patient planned for operative treatment underwent an AFB with Storz D-Light AF after completion of pre-operative staging. During AFB biopsies were only taken from suspicious regions reported as normal in WLB.
Until now 77 patients were investigated, 55 supicious sites were detected in AF-modus. Relevant additional information was obtained in two cases. In one case we found a synchronous Carcinoma in Situ in the contralateral lung resulting in photodynamic therapy (PDT) following operation. In the other case a wider extension of the diagnosed NSCLC was demonstrated with AFB leading to planned pneumonectomy instead of lobe resection.
Until now the rate of additional information detected by AFB relevant for further therapy is 2 out of 77 cases. Therefore AFB has become a regular part in our pre-operative diagnostic of lung cancer.
Although the rate of detected pre-/early malignant changes is not as high as in preceding studies, AFB is useful in the pre-operative diagnostic of lung cancer. We think this study is an argument in favour of the application of AFB in this special risk group.
A. Budahn, None.